干细胞移植前检查点抑制增加了炎症性不良事件的风险
Malek Shatila1, Antonio Pizuorno Machado2, Jay Shah3
1Department of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1466, Houston, TX, 77030, USA.
Targeted oncology
|February 4, 2025
概括
在干细胞移植 (SCT) 之前服用免疫检查点抑制剂 (ICI) 会增加移植后早期炎症不良事件 (AE) 的风险. 在SCT后开始ICI可能会降低这些风险,因此需要进一步调查血液癌症患者的最佳时间.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 干细胞移植 (SCT) 和免疫检查点抑制剂 (ICI) 是血液恶性瘤的关键治疗方法.
- 同时或连续使用SCT和ICI可能会改变治疗疗效和安全性.
- 了解SCT和ICI之间的相互作用对于管理不良事件至关重要.
研究的目的:
- 调查免疫治疗时间相对于SCT对炎症不良事件 (AE) 发生率和特征的影响.
- 为了比较在SCT前与SCT后接受ICI的患者中后SCTAE的风险和严重程度.
主要方法:
- 对接受SCT和免疫治疗的血液性恶性瘤患者的回顾性图表审查.
- 排除没有接受移植后免疫抑制 (例如,自身SCT) 的患者.
- 分类为两组:SCT ICI前 (第一组) 和SCT ICI后 (第二组).
主要成果:
- 在接受SCT前ICI (1组) 的患者中,82%的患者经历了移植后的副作用,而在SCT后ICI组 (2组) 的患者中,这一比例为50%.
- 在第一组中,AE发生的时间明显较早 (中位数为57天而不是195天).
- 胃肠道炎症很常见 (80%),在1组中更可能需要免疫抑制治疗.
结论:
- 在SCT之前使用ICI可能会增加移植后早期和潜在的长期炎症性AE的风险.
- 与SCT相对的ICI时间显著影响炎症性AE的发生和时间.
- 需要进一步的研究来优化SCT和ICI的测序以减轻AE.
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