与使用免疫检查点抑制剂相关的免疫血液溶解性贫血:范围审查
Juan-Manuel Hernandez-Martinez1,2, Eduardo Rios-Garcia1, Cittim B Palomares-Palomares1
1Thoracic Oncology Unit and Experimental Oncology Laboratory, Instituto Nacional de Cancerologiía de Meíxico (INCan), Mexico City, Mexico.
Frontiers in immunology
|July 18, 2025
概括
免疫血液溶解性贫血 (IHA) 是免疫检查点抑制剂 (ICI) 的罕见副作用. 这份对92例病例的综述强调了常见的触发因素,患者的风险因素以及ICI相关的IHA的有效治疗方法.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
背景情况:
- 免疫血液溶解性贫血 (IHA) 是一种罕见的与免疫相关的不良事件 (irAE),与癌症患者的免疫检查点抑制剂 (ICI) 相关.
- 对于ICI相关的IHA,临床数据的整理有限.
研究的目的:
- 对ICI相关IHA的临床特征进行全面的范围审查.
- 确定ICI相关IHA的风险因素和管理策略.
主要方法:
- 从2006年1月到2025年1月的英语文章搜索PubMed和Web of Science核心集合.
- 包括报告ICI相关IHA临床特征的全文出版物.
- 从54篇详细介绍92例病例的出版物中提取了有关患者和IHA特征的数据.
主要成果:
- 确定了92例ICI相关的IHA病例,主要发生在黑色素瘤 (45.2%) 和非小细胞肺癌 (31%) 患者中.
- 布利祖马布 (41.3%) 和尼沃卢马布 (26.1%) 是最常见的触发因素,通常在平均3个周期后作为一线治疗发生.
- 发病率很高,如血液淋巴瘤 (34.8%) 和高血压 (15.2%). 治疗包括ICI中止 (94.6%),葡萄皮质激素 (97.8%) 和输血 (63%),反应率高 (91.3%).
结论:
- 这是关于ICI相关IHA的最大范围审查,综合来自不同来源的数据.
- 患有特定并发症的患者可能面临患ICI相关IHA的更高风险.
- 识别经常同时出现的疾病可以帮助选择患者进行更密切的监测.
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