在这篇文章中,我们探讨免疫检查点抑制剂(ICIs)与中性粒细胞减少的相关性.免疫检查点抑制剂通过最大化免疫系统的先天能力而彻底改变了癌症治疗和管理。然而,这种治疗潜力伴随着一系列免疫相关的不良反应(irAE),包括中性粒细胞减少症,这是这种癌症治疗模式的一种罕见但可能危及生命的副作用。通过对各种病例报告的深入分析,我们编制了一张详细的表格,总结了与不同ICIs相关的中性粒细胞减少症的发生情况,中性粒细胞减少症的等级,使用的治疗方法,和患者结果。中性粒细胞减少症的管理必须包括基于疾病的早期诊断的方法和基于其严重程度的治疗。这篇综述讨论了不同的治疗干预措施,范围从皮质类固醇和静脉注射免疫球蛋白(IVIG)的使用粒细胞集落刺激因子(非格司亭)和,在非常严重的情况下,干细胞移植.我们还列出了这些干预措施引起的明显副作用。我们的研究结果强调,虽然中性粒细胞减少症是ICIs相对罕见的不良反应,其严重性需要提高医疗保健专业人员的认识。随着ICIs继续被视为癌症治疗的组成部分,全面了解中性粒细胞减少的副作用及其管理对于优化患者结局至关重要.这篇综述的一个关键目的是强调需要在获得针对irAE的各种治疗策略的治疗益处和考虑其潜在副作用之间取得平衡,尤其是使用类固醇.实现这种平衡对于优化免疫治疗期间的患者护理非常重要,因为这些irAE治疗方案既可以减轻由ICIs引发的中性粒细胞减少症,又可能引起继发性并发症.因此,仔细评估与每种治疗方法相关的风险和获益对于定制irAE管理至关重要.
In this article, we explore the correlation between immune checkpoint inhibitors (ICIs) and neutropenia. Immune checkpoint inhibitors have revolutionized cancer treatment and management by maximizing the innate abilities of the immune system. However, this therapeutic potential is accompanied by a range of immune-related adverse effects (irAEs), including neutropenia, which is a rare but potentially life-threatening side effect of this mode of cancer treatment. Through an in-depth analysis of various case reports, we have compiled a detailed table summarizing the occurrences of neutropenia associated with different ICIs, the grades of neutropenia, treatments used, and patient outcomes. Management of neutropenia must include an approach based on early diagnosis of the condition and a treatment based on its severity. This review discusses different therapeutic interventions, ranging from the administration of corticosteroids and intravenous immunoglobulin (IVIG) to the use of granulocyte colony-stimulating factor (filgrastim) and, in very severe cases, a stem cell transplant. We have also enlisted salient side effects caused by these interventions. Our findings emphasize that while neutropenia is a relatively rare adverse effect of ICIs, its severity necessitates increased awareness among healthcare professionals. As ICIs continue to be seen as an integral component of cancer therapy, a comprehensive understanding of neutropenia as a side effect and its management is critical for optimizing patient outcomes. A crucial purpose of this review is to highlight the need to achieve a balance between acquiring the therapeutic benefits of various treatment strategies for irAEs and considering their potential side effects, especially with the use of steroids. Achieving this equilibrium is very important in optimizing patient care during immunotherapy, as these irAE management options can both mitigate the neutropenia triggered by ICIs and potentially give rise to secondary complications. Therefore, a careful assessment of the risks and benefits associated with each treatment approach is essential in tailoring irAE management.