与glofitamab相关的肠球炎 - - 在三例病例中首次报告和临床病理学发现
Sean McKeague1, Molly Robertson1, Sam van der Linde1
1Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia.
对B细胞非霍奇金淋巴瘤的glofitamab治疗可能导致肠球炎. 这种以胃肠道炎症为特征的不良事件需要在患有持续性腹或腹痛的患者中进行临床考虑.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
背景情况:
- 格洛菲他马布是一种针对CD3和CD20的双特异性抗体,已被批准用于治疗B细胞非霍奇金淋巴瘤.
- 内肠炎是一种与向免疫疗法相关的潜在不良事件.
研究的目的:
- 描述在一个机构用glofitamab治疗的患者中发生的三起肠肠炎病例.
- 为了确定glofitamab诱导的肠球炎的共同特征,变异性和潜在机制.
主要方法:
- 在glofitamab治疗期间发生肠肠炎的三名患者的回顾性病例系列分析.
- 临床数据审查,包括症状发作,实验室测试 (便calprotectin),成像 (PET扫描) 和组织学.
- 评估治疗反应,特别是对类固醇的反应.
主要成果:
- 内肠炎发生在glofitamab启动后的4-5周期之间.
- 常见的发现包括便calprotectin的升高,在PET扫描 (2/3),缺少CD20+B细胞在肠道活检,和类固醇响应异常的肠道狂热.
- 在胃肠道炎症和症状的位置和严重程度上观察到的变化.
结论:
- 临床医生应对接受glofitamab的患者的肠球炎保持警,特别是在排除感染后患有持续性腹或腹痛的患者.
- 确切的机制尚不清楚,但可能涉及B调节细胞枯竭和T细胞招募.
- 类固醇治疗似乎是这种毒性的有效治疗方法.
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