免疫检查点抑制剂与中枢神经系统的炎症性疾病相关:病例报告和系统性审查
Ting-Ting Yang1, Ze-Yi Wang, Pen-Ju Liu
1Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
免疫检查点抑制剂 (ICI) 可以导致罕见但严重的中枢神经系统 (CNS) 炎症性疾病. 早期检测和治疗对于经历这些神经副作用的患者获得更好的结果至关重要.
科学领域:
- 神经免疫学 神经免疫学
- 在瘤学瘤学.
- 神经学 神经学
背景情况:
- 免疫检查点抑制剂 (ICI) 已经彻底改变了癌症治疗.
- 从ICI的神经免疫相关的不良事件 (irAEs) 是罕见的,但可能致命的.
- 蒂斯莱利祖马布是一种ICI,可以诱导中枢神经系统的炎症性疾病.
研究的目的:
- 报告第一个由tislelizumab引起的中枢神经系统炎症病例.
- 系统地审查ICI诱导的中枢神经系统炎症疾病.
- 分析这些罕见事件的特征和结果.
主要方法:
- 报告了一例由tislelizumab诱导的骨髓炎,脱髓化脑病变和外围神经病变重叠综合征.
- 对ICI相关的中枢神经系统炎症疾病进行了系统的文献综述,使用PubMed和Embase数据库,直到2022年10月.
- 分析了33个病例,包括报告的一例.
主要成果:
- 报告的患者的症状改善了静脉注射甲基prednisolone.
- 在33例病例中,只有8例患有大脑和脊髓损伤.
- 静脉注射类固醇是主要的治疗方法;其他疗法用于耐火病例. 13名患者复发,其中4人死亡.
结论:
- 与ICI相关的中枢神经系统炎症病是一种罕见但危急的疾病,需要及时诊断和管理.
- 对于瘤学家和神经病学家来说,意识到这些神经病情是必不可少的.
- 及时治疗可以导致有利的预后,尽管这些事件的严重性.
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