Younan Romy G, Raad Roy A, Sawan Bassem Y, Said Rabih
Medical Oncology Department, Saint George Hospital University Medical Center and University of Balamand, Beirut, Lebanon.
Medical Imaging Department, Saint George Hospital University Medical Center and University of Balamand, Beirut, Lebanon.
Allergy Asthma Clin Immunol. 2021 Oct 26;17(1):112. doi: 10.1186/s13223-021-00616-4.
Treatment with immune checkpoint inhibitors has revolutionized cancer treatment over the past several years. Despite their clinical benefits, a wide range of immune-mediated toxicities can be observed including hematological toxicities. Although, the majority can easily be managed, immune-mediated adverse events rarely can be severe and difficult to approach. Herein, we are reporting a case of very severe aplastic anemia secondary to ipilimumab (I) and nivolumab (N) treatment that failed various treatment including intensive immune suppressive therapy.
We described a case of a 45-year old white male, heavy smoker presented to the clinic complaining of left flank pain. He was found to have a metastatic renal cell carcinoma for which he was treated with dual immunotherapy and later complicated by severe immune related adverse events. The patient later died after failing intensive immune suppressive therapy.
Immunotherapy has become an established pillar of cancer treatment improving the prognosis of many patients with variant malignancies. Yet, lethal adverse events can occur in rare cases. It is our duty, as physicians, to remain alert and cautious.
在过去几年中，免疫检查点抑制剂治疗彻底改变了癌症治疗方式。尽管它们具有临床益处，但仍可观察到广泛的免疫介导毒性，包括血液学毒性。虽然大多数情况易于处理，但免疫介导的不良事件很少会很严重且难以应对。在此，我们报告一例因伊匹木单抗（I）和纳武单抗（N）治疗继发的非常严重的再生障碍性贫血病例，该病例对包括强化免疫抑制治疗在内的各种治疗均无效。
我们描述了一例45岁的白人男性重度吸烟者，因左侧胁腹疼痛就诊。他被诊断为转移性肾细胞癌，接受了双重免疫治疗，后来并发严重的免疫相关不良事件。该患者在强化免疫抑制治疗无效后死亡。
免疫疗法已成为癌症治疗的既定支柱，改善了许多不同恶性肿瘤患者的预后。然而，在罕见情况下可能会发生致命的不良事件。作为医生，我们有责任保持警惕和谨慎。
