Department of Critical Care, Division of Anesthesiology and Critical Care, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard. Houston, TX 77030, USA.
Stem Cell Transplant and Oncology Intensive Care Unit, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, 4523 Clayton Ave, St Louis, MO 63110, USA.
Crit Care Clin. 2021 Jul;37(3):605-624. doi: 10.1016/j.ccc.2021.03.004.
As the cancer population increases and immunotherapy becomes widely utilized, severe toxicities from these treatments will become more prevalent. In cancer patients, the most common immunotherapies that lead to critical illness are chimeric antigen receptor T cells, monoclonal antibodies, and immune checkpoint inhibitors. Awareness of their toxicities by the intensive care unit team is of extreme importance. A multidisciplinary approach for diagnosis and treatment is recommended. This article reviews the most common toxicities from immunotherapy and offers a therapy-specific and system-based approach for affected patients.
随着癌症患者人数的增加和免疫疗法的广泛应用,这些治疗方法的严重毒性将更为普遍。在癌症患者中,导致重症的最常见免疫疗法是嵌合抗原受体 T 细胞、单克隆抗体和免疫检查点抑制剂。重症监护病房团队对这些毒性的认识至关重要。建议采用多学科方法进行诊断和治疗。本文回顾了免疫疗法最常见的毒性,并为受影响的患者提供了一种基于治疗和系统的方法。