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一名接受帕博利珠单抗治疗的食管癌患者发生的淋巴增殖性疾病

Lymphoproliferative Disorder in an Esophageal Cancer Patient Treated with Pembrolizumab.

作者信息

Matsumura Takashi, Tsuchihashi Kenji, Yamamoto Takeo, Jinnouchi Fumiaki, Kusano Wataru, Kusumoto Yota, Arimizu Kohei, Ohmura Hirofumi, Kuma Yuki, Moriyama Shohei, Yamaguchi Kyoko, Ito Mamoru, Isobe Taichi, Ariyama Hiroshi, Oda Yoshinao, Akashi Koichi, Baba Eishi

机构信息

Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Japan.

Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Japan.

出版信息

Intern Med. 2025 Jun 1;64(11):1728-1732. doi: 10.2169/internalmedicine.3743-24. Epub 2024 Oct 18.

DOI:10.2169/internalmedicine.3743-24
PMID:39428537
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12222906/
Abstract

A 75-year-old man diagnosed with esophageal cancer and lung metastasis received a combination of fluorouracil, cisplatin, and pembrolizumab. During pembrolizumab maintenance therapy, lymphoproliferative lesions at the lips and mouth and multiple lymph node swellings appeared. Histologically, Epstein-Barr virus (EBV)-encoded RNA was positive, and EBV-DNA was detected in the blood. The patient was diagnosed with other iatrogenic immunodeficiency-associated lymph proliferative disorders (OIIA-LPDs) related to EBV activation induced by pembrolizumab. Rituximab was administered, resulting in the improvement of the OIIA-LPD. The emergence of an OIIA-LPD merits close attention in patients receiving immune checkpoint inhibitors.

摘要

一名75岁被诊断为食管癌伴肺转移的男性接受了氟尿嘧啶、顺铂和帕博利珠单抗的联合治疗。在帕博利珠单抗维持治疗期间，嘴唇和口腔出现淋巴增殖性病变以及多处淋巴结肿大。组织学检查显示，爱泼斯坦-巴尔病毒（EBV）编码的RNA呈阳性，血液中检测到EBV-DNA。该患者被诊断为与帕博利珠单抗诱导的EBV激活相关的其他医源性免疫缺陷相关淋巴增殖性疾病（OIIA-LPDs）。给予利妥昔单抗治疗后，OIIA-LPD得到改善。接受免疫检查点抑制剂治疗的患者出现OIIA-LPD值得密切关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4914/12222906/fe5a78cfc82f/1349-7235-64-11-1728-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4914/12222906/2bab9bb50948/1349-7235-64-11-1728-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4914/12222906/fe5a78cfc82f/1349-7235-64-11-1728-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4914/12222906/2bab9bb50948/1349-7235-64-11-1728-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4914/12222906/fe5a78cfc82f/1349-7235-64-11-1728-g002.jpg

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本文引用的文献

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[Angioimmunoblastic T-cell lymphoma after immune checkpoint inhibitor-combined chemotherapy for lung cancer].[免疫检查点抑制剂联合化疗治疗肺癌后发生血管免疫母细胞性T细胞淋巴瘤]
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