应用抗PD-1抗体治疗恶性淋巴瘤致少见不良反应的临床报告

Clinical reports of rare adverse effect caused by anti-PD-1 antibody in malignant lymphomas

目的:探讨抗PD-1抗体治疗恶性淋巴瘤导致的少见不良反应。方法:收集使用过抗PD-1抗体的肿瘤患者的临床资料,分析这些患者发生不良反应的情况,从中筛选出少见的不良反应病例。结果:华中科技大学同济医学院附属同济医院3年间有157例肿瘤患者使用抗PD-1抗体治疗,大部分不良反应较轻无需治疗,其中4例患者发生少见不良反应,分别为免疫性脑炎、心肌炎、垂体功能紊乱和间质性肺炎。通过复习文献,考虑上述不良反应为抗PD-1抗体所致的免疫相关不良反应。结论:临床工作中需要警惕抗PD-1抗体可能导致的少见不良反应,尽早诊断和治疗,将不良反应的危害降至最低。

Objective To discuss the rare adverse effects caused by anti-PD-1 antibody in patients with malignant lymphomas. Methods: The clinical data of the patients who had received anti-PD-1 antibody treatment were collected, and the adverse events were analyzed. Patients with rare adverse events were selected. Results: 157 patients had received anti-PD-1 antibody treatment during the 3 years. Most adverse events were mild that didn’t need any treatment. However, 4 patients suffered from rare adverse events, including autoimmune encephalitis, myocarditis, pituitary malfunction and interstitial pneumonia, respectively. These adverse events were considered as immune-related adverse events caused by anti-PD-1 antibody. Conclusion: Clinical doctors must pay attention to rare adverse events caused by anti-PD-1 antibody. The diagnosis and treatment should be given as soon as possible, so as to minimize the damage to patients.