■免疫检查点抑制剂与噬血细胞淋巴组织细胞增多症(HLH)之间存在关联。因此,这项研究的主要目的是收集这种罕见但可能危及生命的免疫相关不良反应的数据,以确定导致这种不良反应的药物,临床特征,和有效的治疗方法。
■分析了2014年8月至2024年3月发表的有关导致HLH的免疫检查点抑制剂的中英文文献。免疫检查点抑制剂,免疫疗法,抗PD-1,PD-L1抑制剂,HLH,噬血细胞淋巴组织细胞增生症,噬血细胞综合征关键词在中国知网查找文献,万方,PubMed和Emabase数据库。
■纳入24项研究,共有27名患者(18名男性和9名女性),平均年龄58岁(范围26-86)。症状出现的平均时间为10.3周(7天至14个月)。主要临床特征为发热,血细胞减少,脾肿大,高铁血红蛋白血症,低纤维蛋白原血症,骨髓活检显示吞噬作用。22名患者在接受类固醇治疗后有所改善,细胞因子阻断治疗和对症治疗,四名病人死亡,一名患者未被描述。
■HLH不应被低估为免疫检查点抑制剂的潜在严重不良反应,因为适当的治疗可以挽救患者的生命。
UNASSIGNED: An association exists between immune checkpoint inhibitors and hemophagocytic lymphohistiocytosis (HLH). Therefore, the main objective of this study was to collect data on this rare but potentially life-threatening immune-related adverse reaction to identify the medications that cause it, the clinical characteristics, and effective treatments.
UNASSIGNED: Literature in English and Chinese on immune checkpoint inhibitors causing HLH published from August 2014 to March 2024 was analyzed. Immune checkpoint inhibitors, immunotherapy, anti-PD-1, PD-L1 inhibitors, HLH, hemophagocytic lymphohistiocytosis, hemophagocytic syndrome keywords were used to find the literature on China Knowledge Network, Wanfang, PubMed and Emabase Databases.
UNASSIGNED: Twenty-four studies were included, with a total of 27 patients (18 males and 9 females) with a mean age of 58 years (range 26-86). The mean time to the onset of symptoms was 10.3 weeks (7 days-14 months). The main clinical characteristics were fever, cytopenia, splenomegaly, methemoglobinemia, hypofibrinogenemia, and bone marrow biopsy showed phagocytosis. Twenty-two patients improved after the treatment with steroids, cytokine blocking therapy and symptomatic treatment, four patients died, and one patient was not described.
UNASSIGNED: HLH should be not underestimated as a potentially serious adverse effect of immune checkpoint inhibitors since appropriate treatments may save the life of patients.