Chełmińska Marta, Specjalski Krzysztof, Jassem Ewa, Polańska Joanna, Kita Karolina, Górska Lucyna, Didkowska Joanna, Wojciechowska Urszula, Nittner-Marszalska Marita, Kuna Piotr, Kupczyk Maciej, Kruszewski Jerzy, Zakrzewski Aleksander, Czarnobilska Ewa, Stobiecki Marcin, Krenke Rafał, Dąbrowski Andrzej, Kwaśniewski Artur, Jarząb Jerzy, Bożek Andrzej, Bodzenta-Łukaszyk Anna, Łukaszyk Mateusz, Kowalski Marek, Smorawska-Sabanty Ewa, Fal Andrzej, Przybyłowska Katarzyna, Bartuzi Zbigniew, Pałgan Krzysztof, Niedoszytko Marek
Department of Allergology, Medical University of Gdańsk, 80-952 Gdańsk, Poland.
Department of Pneumonology, Medical University of Gdańsk, 80-952 Gdańsk, Poland.
J Clin Med. 2024 May 28;13(11):3152. doi: 10.3390/jcm13113152.
Allergen immunotherapy (AIT) is a well-established and efficient method of causative treatment for allergic rhinitis, asthma and insect venom allergy. Traditionally, a recent history of malignant neoplasm is regarded as a contraindication to AIT due to concerns that AIT might stimulate tumor growth. However, there are no data confirming that the silencing of the Th2 response affects prognosis in cancer. The aim of this study was to investigate frequency of malignant tumors in patients undergoing AIT and the association between AIT and cancer-related mortality. A group of 2577 patients with insect venom allergy undergoing AIT in 10 Polish allergology centers was screened in the Polish National Cancer Registry. Data on cancer type, diagnosis time and patients' survival were collected and compared with the general population. In the study group, 86 cases of malignancies were found in 85 patients (3.3% of the group). The most common were breast (19 cases), lung (9 cases), skin (8 cases), colon and prostate cancers (5 cases each). There were 21 cases diagnosed before AIT, 38 during and 27 after completing AIT. Laplace's crude incidence rate was 159.5/100,000/year (general population rate: 260/100,000/year). During follow-up, 13 deaths related to cancer were revealed (15% of patients with cancer). Laplace's cancer mortality rate was 37.3/100,000/year (general population rate: 136.8/100,000/year). Malignancy was found in patients undergoing immunotherapy less often than in the general population. Patients with cancer diagnosed during or after AIT did not show a lower survival rate, which suggests that AIT does not affect the prognosis.
变应原免疫疗法（AIT）是一种成熟且有效的变应性鼻炎、哮喘和昆虫毒液过敏的病因治疗方法。传统上，由于担心AIT可能刺激肿瘤生长，恶性肿瘤近期病史被视为AIT的禁忌证。然而，尚无数据证实Th2反应的抑制会影响癌症的预后。本研究的目的是调查接受AIT治疗的患者中恶性肿瘤的发生率以及AIT与癌症相关死亡率之间的关联。在波兰国家癌症登记处对在10个波兰过敏症中心接受AIT治疗的2577例昆虫毒液过敏患者进行了筛查。收集了癌症类型、诊断时间和患者生存数据，并与普通人群进行比较。在研究组中，85例患者中发现了86例恶性肿瘤（占该组的3.3%）。最常见的是乳腺癌（19例）、肺癌（9例）、皮肤癌（8例）、结肠癌和前列腺癌（各5例）。在AIT之前诊断出21例，治疗期间诊断出38例，完成AIT后诊断出27例。拉普拉斯粗发病率为159.5/100,000/年（普通人群发病率：260/100,000/年）。在随访期间，发现13例与癌症相关的死亡（占癌症患者的15%）。拉普拉斯癌症死亡率为37.3/100,000/年（普通人群死亡率：136.8/100,000/年）。接受免疫治疗的患者中恶性肿瘤的发生率低于普通人群。在AIT期间或之后诊断出癌症的患者并未显示出较低的生存率，这表明AIT不影响预后。
