免疫检查点抑制剂相关的大脑小细胞毒性:临床特征和与神经发育性大脑小细胞缩症的比较
Marta Dentoni1,2, Irene Florean1,2, Antonio Farina3,4
1Clinical Neurology, Department of Medicine (DMED), University of Udine, Udine, Italy.
Cerebellum (London, England)
|August 17, 2024
概括
免疫检查点抑制剂可以导致小脑免疫相关不良事件 (irAEs). 这些事件在瘤类型,临床表现和患者结果方面不同于瘤性大脑动症.
科学领域:
- 神经瘤学神经瘤学
- 免疫学 免疫学 免疫学
- 神经学 神经学
背景情况:
- 免疫检查点抑制剂 (ICI) 已经改变了癌症治疗,但可以引起与免疫相关的不良事件 (irAEs).
- 大脑小脑IREs的定义不清楚,它们与神经瘤大脑小脑无力衰竭 (PCA) 的区别不清楚.
研究的目的:
- 为了表征大脑小脑IRAEs.
- 为了比较大脑小肠的IRAE与PCA.
主要方法:
- 多中心,回顾性队列研究ICI诱导的小脑功能障碍患者.
- 按照PRISMA指南进行系统审查.
- 与PCA患者的小脑IRAE病例的比较.
主要成果:
- 分析了35名患有小脑性irrAEs的患者;48%的患者有神经元抗体,83%的患者表现出炎症性脑脊液.
- 脑小细胞IRAE与男性性别,非小细胞肺癌有关,与PCA相比,它们显示出更好的结果.
- 在大多数患者中,ICI治疗导致改善,尽管残留残疾很常见.
结论:
- 脑膜IRAE是一种独特的临床实体,具有特定的关联和结果.
- 脑小细胞IRAE和PCA之间存在瘤关联,临床特征和预后的差异.
- 临床表现-抗体-瘤三元组在ICI相关的小脑功能障碍中仅部分反映了副瘤性疾病.
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