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粒细胞集落刺激因子诱导的主动脉炎的文献综述分析

Literature review analysis of aortitis induced by granulocyte-colony stimulating factor.

作者信息

Zhao Ting, Xu Huanhuan

机构信息

Department of Clinical Pharmacy, Weifang People's Hospital, Shandong Second Medical University, Weifang, China.

出版信息

Front Pharmacol. 2024 Dec 18;15:1487501. doi: 10.3389/fphar.2024.1487501. eCollection 2024.

Abstract

BACKGROUND

Recombinant human granulocyte-colony stimulating factors (G-CSF)-induced aortitis is a rare but particularly serious adverse event, commonly seen in cancer patients undergoing chemotherapy. The aim of this article is to clarify the clinical characteristics of G-CSF- induced aortitis and provide effective references for clinical diagnosis and intervention.

METHODS

Case reports of adverse reactions of aortitis induced by G-CSF were collected from the relevant databases. The patients' basic information and adverse reaction process were recorded and subjected to descriptive analysis.

RESULTS

A total of 72 patients were enrolled, including 14 males and 58 females, with a mean age of 61.83 ± 10.30 years. The G-CSF type with the highest frequency of occurrence of aortitis is pegfilgrastim. Apart from three healthy stem cell donors, G-CSF-induced aortitis was primarily found in patients with underlying malignancies, especially in patients with breast cancer. The most common anticancer drugs used at onset were docetaxel, cyclophosphamide, and doxorubicin. CT scan showed that aortitis most commonly occured in the aortic arch and its branches. Most patients had a good prognosis, but 3 cases developed complications. Importantly, G-CSF-induced aortitis was also found in 4 asymptomatic patients.

CONCLUSION

This article found that G-CSF-induced aortitis not only occured in cancer patients undergoing chemotherapy as previously reported in literature, but also in healthy stem cell donors. Especially, asymptomatic patients with G-CSF-induced aortitis faced a greater risk of being missed by the attending physician.

摘要

背景

重组人粒细胞集落刺激因子(G-CSF)诱导的主动脉炎是一种罕见但特别严重的不良事件,常见于接受化疗的癌症患者。本文旨在阐明G-CSF诱导的主动脉炎的临床特征,并为临床诊断和干预提供有效的参考依据。

方法

从相关数据库收集G-CSF诱导的主动脉炎不良反应的病例报告。记录患者的基本信息和不良反应过程,并进行描述性分析。

结果

共纳入72例患者,其中男性14例,女性58例,平均年龄61.83±10.30岁。发生主动脉炎频率最高的G-CSF类型是聚乙二醇化重组人粒细胞刺激因子。除3名健康干细胞供者外,G-CSF诱导的主动脉炎主要见于有潜在恶性肿瘤的患者,尤其是乳腺癌患者。发病时最常用的抗癌药物是多西他赛、环磷酰胺和阿霉素。CT扫描显示主动脉炎最常见于主动脉弓及其分支。大多数患者预后良好,但有3例出现并发症。重要的是,在4例无症状患者中也发现了G-CSF诱导的主动脉炎。

结论

本文发现G-CSF诱导的主动脉炎不仅如文献先前报道的那样发生在接受化疗的癌症患者中,也发生在健康干细胞供者中。特别是,G-CSF诱导的主动脉炎无症状患者被主治医生漏诊的风险更大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db45/11688214/914fd65c6827/fphar-15-1487501-g001.jpg

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