替雷利珠单抗免疫相关不良事件二例
Immune-related adverse reactions caused by tislelizumab:two cases report
周永芳 1司瑞丽 1武圆圆 1李培培 1刘宗展1
作者信息
- 1. 济宁肿瘤医院 肿瘤科,山东 济宁 272000
- 折叠
摘要
本文病例1使用替雷利珠单抗后出现红斑、疱疹、脓疱面积大于30%,伴自理能力受限,为G3级皮肤免疫相关不良事件(irAEs),虽然皮肤irAEs是替雷利珠单抗常见不良反应,但该患者首发部位在肿瘤病灶同侧的关节旁,容易被忽略,继续使用替雷利珠单抗后,皮肤irAEs范围迅速扩大至全身.在国内外多个数据库中,均未检索到irAEs的发生部位(关节旁)与肿瘤病灶位置相关报道.病例2使用替雷利珠单抗后出现甲状腺功能减退,且出现少见的肌酸激酶水平显著升高以及罕见的心包积液.2例患者早期积极治疗后均好转.本文结合文献,分析替雷利珠单抗irAEs的特点、治疗方法、免疫再挑战及预后的相关因素,以促进临床用药安全.
Abstract
In case 1,the patient experienced erythema,herpes,and pustules covering more than 30%of the body area,accompanied by limited self-care ability after using tislelizumab,which was considered as grade 3 cutaneous immune-related adverse events(irAEs).Although cutaneous irAEs are common adverse reactions of tislelizumab,the initial onsite of the pa-tient's skin irAEs was adjacent to the joint on the same side of the tumor,which was easy to ignore.The scope of cutaneous irAEs rapidly expanded to the whole body.No reports in multiple domestic and international databases have mentioned the cor-relation between the occurrence site(para-articular)of skin irAEs and the location of tumor lesions.In case 2,the patient de-veloped hypothyroidism after using tislelizumab,along with a rare significant increase in creatine kinase level and an extremely rare pericardial effusion.Both patients improved after early active treatment.Combined with the literature,this article analyzes the characteristics,treatment methods,immune rechallenge,and prognostic factors related to tislelizumab irAEs,to promote clinical medication safety.
关键词
替雷利珠单抗/免疫检查点抑制剂/免疫相关不良事件Key words
tislelizumab/immune checkpoint inhibitors/immune-related adverse events引用本文复制引用
出版年
2024
NETL
NSTL
万方数据