帕博利珠单抗所致的伴有肝炎的迟发性免疫相关性中性粒细胞减少症。
Delayed immune-related neutropenia with hepatitis by pembrolizumab.
作者信息
Nakako Soichiro, Nakashima Yasuhiro, Okamura Hiroshi, Tani Yoko, Ueda Takahiro, Makuuchi Yosuke, Kuno Masatomo, Takakuwa Teruhito, Nishimoto Mitsutaka, Koh Hideo, Nakamae Hirohisa, Hino Masayuki
机构信息
Hematology, Graduate School of Medicine, Osaka City University, Osaka, 545-8585, Japan.
Clinical Oncology, Graduate School of Medicine, Osaka City University, Osaka, 545-8585, Japan.
出版信息
Immunotherapy. 2022 Feb;14(2):101-105. doi: 10.2217/imt-2021-0131. Epub 2021 Nov 11.
A 72-year-old man with non-small-cell lung cancer received four cycles of pembrolizumab-containing chemotherapy. He developed multiple immune-related adverse events (irAEs) and discontinued immune checkpoint inhibitors (ICIs); however, he developed immune-related hepatitis and grade 4 neutropenia at 92 days and 118 days, respectively, from discontinuation. He received G-CSF and methylprednisolone pulse therapy and recovered from neutropenia 12 days later. ICI-induced neutropenia is a life-threatening condition. The longest recorded onset in one study cohort is 26 days after the final administration of ICIs. This case developed strikingly delayed immune-related neutropenia manifesting as a delayed irAE. Clinicians should pay close attention to delayed immune-related neutropenia as a possible life-threatening irAE after ICI treatment.
一名72岁的非小细胞肺癌男性患者接受了四个周期含帕博利珠单抗的化疗。他出现了多种免疫相关不良事件（irAE），并停用了免疫检查点抑制剂（ICI）；然而，他在停用后分别于第92天和第118天出现了免疫相关肝炎和4级中性粒细胞减少。他接受了粒细胞集落刺激因子（G-CSF）和甲泼尼龙冲击治疗，并在12天后从中性粒细胞减少中恢复。ICI诱导的中性粒细胞减少是一种危及生命的状况。在一个研究队列中记录的最长发病时间是在最后一次使用ICI后26天。该病例出现了显著延迟的免疫相关中性粒细胞减少，表现为延迟性irAE。临床医生应密切关注延迟性免疫相关中性粒细胞减少，将其作为ICI治疗后可能危及生命的irAE。
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