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接受特瑞普利单抗治疗的患者发生致命细胞因子释放综合征:病例报告。

Fatal cytokine-release syndrome in a patient receiving toripalimab: a case report.

机构信息

Department of Chemoradiotherapy, Tangshan People's Hospital, No. 65, Shengli Road, Lunan District, Tangshan, 063000, Hebei Province, China.

The Cancer Institute, Tangshan People's Hospital, Tangshan, Hebei, 063000, Hebei Province, China.

出版信息

Immunotherapy. 2023 Jun;15(9):641-645. doi: 10.2217/imt-2022-0289. Epub 2023 May 4.

DOI:10.2217/imt-2022-0289
PMID:37139989
Abstract

Immune checkpoint inhibitors, a type of immunotherapy, have demonstrated optimal treatment efficacy in inducing durable antitumor responses in various cancers. Cytokine-release syndrome is a rare immune-related adverse event induced by immune checkpoint inhibitors. In our case, a patient with hypopharyngeal squamous cell carcinoma received toripalimab combined with chemotherapy. On the fourth day post treatment, the patient developed fever and hypotension. Laboratory examination indicated myelosuppression, acute kidney injury and disseminated intravascular coagulation. Meanwhile, serum cytokine levels of IL-6, IL-8, IL-10, IL-1β, IFN-γ and the level of hypersensitive C-reactive protein were markedly elevated. The patient was diagnosed with cytokine release syndrome, which progressed rapidly and led to the patient's demise on the fifth day post treatment.

摘要

免疫检查点抑制剂是一种免疫疗法,已在各种癌症中显示出诱导持久抗肿瘤反应的最佳治疗效果。细胞因子释放综合征是免疫检查点抑制剂引起的罕见免疫相关不良反应。在我们的病例中,一名下咽鳞状细胞癌患者接受了特瑞普利单抗联合化疗。治疗后第 4 天,患者出现发热和低血压。实验室检查提示骨髓抑制、急性肾损伤和弥散性血管内凝血。同时,血清细胞因子水平如 IL-6、IL-8、IL-10、IL-1β、IFN-γ和超敏 C 反应蛋白水平显著升高。患者被诊断为细胞因子释放综合征,病情迅速进展,导致患者在治疗后第 5 天死亡。

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