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在杜尔瓦卢马布治疗后出现复发性子宫内膜癌与免疫媒介性血小板缩:一个病例报告

Ami Sakakibara^1,2, Shimpei Nagai^1,2, Terumi Shirane¹

¹Department of Obstetrics and Gynecology, National Hospital Organization Saitama Hospital, Saitama, Japan.

Case reports in women's health

|December 25, 2025

概括

像杜尔瓦卢马布这样的免疫检查点抑制剂在子宫内膜癌的治疗中表现有前途. 然而,严重的免疫血小板减少是一种罕见但严重的副作用,需要立即临床治疗.

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:

免疫检查点抑制剂 (ICI) 已为晚期或复发性子宫内膜癌提供了先进的治疗方法.
杜尔瓦卢马布是一种编程死亡配体1 (PD-L1) 抑制剂,在DUO-E试验中显示出临床益处.
免疫性血小板缺血 (ITP) 是一种罕见但严重的免疫相关不良事件 (irAE).

研究的目的:

在日本报告了患有子宫内膜癌的患者中第一个与杜尔瓦卢马布相关的ITP病例.
为了突出在杜尔瓦卢马布治疗期间严重的ITP作为irAE的潜力.
强调早期识别和管理ITP的重要性.

主要方法:

一个73岁妇女的病例报告,患有复发性子宫内膜癌,接受了帕克利塔塞尔,卡博普拉丁和杜尔瓦卢马布治疗.
治疗后对血小板计数和临床表现的监测.
静脉注射免疫球蛋白 (IVIG) 和高剂量静脉注射普雷尼索隆用于疑似ITP.

主要成果:

患者在三轮杜尔瓦卢马布联合治疗后出现严重的ITP,血小板数低至1×10^3/μL.
患者出现并发症,包括炎炎,细菌病和扩散性血管内凝血 (DIC).
用IVIG和普雷迪尼索隆治疗导致血小板数逐渐改善至85 × 10 ^ 3 /μL.

结论:

对子宫内膜癌的杜尔瓦卢马布治疗可能与严重的免疫性血小板缩有关.
临床医生必须在接受杜尔瓦卢马布的患者中保持对ITP的高度怀疑指数,特别是在意想不到的血小板缺血或出血的情况下.
及时诊断和启动ITP治疗对于患者的结果至关重要.

关键词:

在 Durvalumab 中使用.宫内膜癌 (Endometrial carcinoma) 是一种子宫内膜癌.免疫检查点抑制剂免疫检查点抑制剂免疫性血小板减少症.与免疫相关的不良事件.

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