Hematology and Oncology, Department of Internal Medicine, School of Medicine, Iwate Medical University, 2-1-1 Idaidori, Shiwa-gun, Yahaba-cho, Iwate, Japan.
Department of Hematology, Hachinohe Red Cross Hospital, Hachinohe, Japan.
Int J Hematol. 2023 Dec;118(6):751-757. doi: 10.1007/s12185-023-03644-5. Epub 2023 Jul 24.
A 37-year-old man with refractory classical Hodgkin lymphoma (cHL) underwent PD-1 blockade therapy with nivolumab, which resulted in a partial response. However, treatment was discontinued due to immune-related adverse events (irAEs), including myasthenia gravis and myositis. Retreatment with nivolumab resulted in a complete metabolic response and hepatic irAE. Subsequently, nivolumab was administered at extended dosing intervals. Intermittent infusion of ten doses of nivolumab for a total dose of 2400 mg/body helped control the relapsed/refractory cHL over three years. During nivolumab treatment, disease progression and emergence of irAEs were associated with the proportion of CD8 + T cells expressing nivolumab-free PD-1 relative to the total number of CD8 + T cells. The findings in this nivolumab-sensitive patient highlight the clinical utility of monitoring immune cells expressing nivolumab-free PD-1 in patients with cHL who have been treated with nivolumab and have experienced irAEs.
一位 37 岁的难治性经典霍奇金淋巴瘤（cHL）男性患者接受了 PD-1 阻断疗法（nivolumab），结果出现部分缓解。然而，由于免疫相关不良事件（irAEs），包括重症肌无力和肌炎，停止了治疗。重新使用 nivolumab 导致完全代谢反应和肝 irAE。随后，nivolumab 的给药间隔延长。间歇性输注 10 剂，总剂量为 2400mg/体，有助于控制复发/难治性 cHL 超过 3 年。在 nivolumab 治疗期间，疾病进展和 irAEs 的出现与表达 nivolumab 游离 PD-1 的 CD8+T 细胞相对于总 CD8+T 细胞的比例相关。在这名对 nivolumab 敏感的患者中，这些发现突出了监测接受 nivolumab 治疗并经历过 irAEs 的 cHL 患者中表达 nivolumab 游离 PD-1 的免疫细胞的临床实用性。
