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免疫检查点抑制剂和内分泌病在儿童脑瘤患者的免疫检查点抑制剂和内分泌病

Carly R Westermann¹, Tom B Davidson^2,3, Kaaren Waters²

¹Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA.

Journal of pediatric endocrinology & metabolism : JPEM

|December 16, 2024

概括

接受免疫检查点抑制剂 (ICI) 的儿童脑瘤患者有甲状腺监测,但非甲状腺内分泌监测是有限的. 甲状腺功能低下是ICI治疗后发现的主要内分泌问题.

科学领域:

儿科瘤学儿科瘤学
内分泌学在内分泌学.
免疫治疗是一种免疫疗法.

背景情况:

免疫检查点抑制剂 (ICI) 越来越多地用于儿科脑瘤.
由于瘤的位置和治疗,患者面临内分泌病变的风险.
ICI的内分泌不良反应 (irAEs) 在成年人中很常见,但在儿童中缺乏研究.

研究的目的:

评估儿童脑瘤患者ICI启动前后的内分泌监测实践.
为了确定内分泌IRAE在这个人群中的发病率.

主要方法:

对22名小儿脑瘤患者的回顾性图表审查,这些患者接受了ICI治疗.
对内分泌实验室结果,人口统计和治疗过程的分析.
从洛杉矶儿童医院 (2010-2022) 收集的数据.

主要成果:

82%的患者在ICI前进行了内分泌监测,主要是甲状腺功能测试 (100%).
在ICI前,非甲状腺内分泌功能很少被评估 (6-22%).
在ICI后的9%患者中诊断出甲状腺功能低下症;对于非甲状腺系统,持续监测是有限的.

结论:

甲状腺监测在接受ICI的儿科脑瘤患者中很常见,识别甲状腺功能低下症与成人数据相似.
需要对内分泌系统进行全面的监测,特别是对非甲状腺系统.
这项研究强调了在接受免疫治疗的儿科患者系统内分泌监测的必要性.

关键词:

大脑瘤是个大脑瘤内分泌诊断诊断内分泌诊断免疫检查点抑制剂免疫检查点抑制剂与免疫相关的不良事件.儿科儿科儿科儿科

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