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帕博利珠单抗治疗艾滋病患者的进行性多灶性白质脑病(PML):病例报告及文献综述

Pembrolizumab for the treatment of Progressive Multifocal Leukoencephalopathy (PML) in a patient with AIDS: A case report and literature review.

作者信息

Chatterjee Tulika, Roy Moni, Lin Rone-Chun, Almoujahed Mohammad O, Ahmad Sharjeel

机构信息

University of Illinois College of Medicine at Peoria, 530 NE Glen Oak Ave, Peoria, IL 61637, USA.

University of Illinois College of Medicine at Peoria, USA.

出版信息

IDCases. 2022 May 20;28:e01514. doi: 10.1016/j.idcr.2022.e01514. eCollection 2022.

Abstract

Progressive multifocal leukoencephalopathy (PML) is an opportunistic central nervous system (CNS) infection caused by the reactivation of John Cunningham polyomavirus (JCV) from suppression of the host immune system due to conditions such as human immunodeficiency virus causing acquired immunodeficiency syndrome (HIV/AIDS), hematological malignancies, multiple sclerosis, and use of immunosuppressant medications. Pembrolizumab is an immune checkpoint inhibitor targeting programmed cell death protein-1 (PD-1) receptors on lymphocytes. In recent years its use is expanding to treat several malignancies and it is a drug of interest for the treatment of PML. In this case report, we present a case of an HIV/AIDS patient who was given a trial of pembrolizumab for treatment of PML. We also provide a literature review of the reported cases of use of this medication in other immunocompromised states.

摘要

进行性多灶性白质脑病(PML)是一种机会性中枢神经系统(CNS)感染,由约翰·坎宁安多瘤病毒(JCV)在宿主免疫系统因人类免疫缺陷病毒导致获得性免疫缺陷综合征(HIV/AIDS)、血液系统恶性肿瘤、多发性硬化症以及使用免疫抑制药物等情况而受到抑制时重新激活所致。帕博利珠单抗是一种靶向淋巴细胞上程序性细胞死亡蛋白-1(PD-1)受体的免疫检查点抑制剂。近年来,其应用范围不断扩大,用于治疗多种恶性肿瘤,是治疗PML的一种受关注药物。在本病例报告中,我们呈现了一例HIV/AIDS患者接受帕博利珠单抗治疗PML的试验病例。我们还对该药物在其他免疫功能低下状态下应用的报道病例进行了文献综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c9f/9144385/e9d5d977f422/gr1.jpg

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