GD-2单抗治疗高危/难治神经母细胞瘤儿童的临床诊治体会

Clinical diagnosis and treatment of pediatric neuroblastoma with high risk of recurren and refractory by anti-GD-2 immunotherapy

目的:探讨GD-2单抗免疫治疗高危及复发难治神经母细胞瘤患儿的临床反应及治疗效果。方法:回顾性分析22例接受GD-2单抗免疫治疗的儿童神经母细胞瘤患者,分析GD-2单抗免疫治疗的耐受性、不良反应及短期治疗效果评估。结果:22例患者在接受GD-2单抗免疫治疗过程的不同治疗周期中均出现发热症状:其中第1个治疗周期出现发热为100%,平均热峰39.0℃,平均持续时间6.75 d;5例(22%)患者出现感染,8例(36%)患者出现疼痛反应,11例(50%)患者发生腹泻,2例(9%)患者发生过敏反应,2例(9%)患者发生轻度毛细血管渗漏综合征(CLS);其中5个患者完成5个治疗周期,经评估1例病情明显好转,2例病情稳定无进展,1例病灶较前缩小,1例复发。结论:GD-2单抗免疫治疗对儿童神经母细胞瘤具有良好的安全性和耐受性,其远期疗效需进一步随访评估。

Objective:To retrospectively analyze the clinical response and therapeutic effect of anti-GD-2 immunotherapy in children with high-risk recurrent refractory neuroblastoma.Methods:A total of 22 pediatric neuroblastoma patients receiving anti-GD-2 immunotherapy were selected as samples in the retrospective analysis including:The tolerance,adverse reactions and short-term efficacy evaluation of anti-GD-2 immunotherapy were analyzed.Result:Twenty-two patients had fever symptoms in different treatment cycles of anti-GD-2 immunotherapy;the probability of fever in the first treatment cycle was 100%,with an average thermal peak of 39.0°℃C and an average duration of 6.75 days;Infection occurred in 5 patients(22%);Pain reaction occurred in 8 cases(36%);Diarrhea occurred in 11 patients(50%);anaphylaxis occurred in 2 patients,the incidence was about 9%;Mild capillary leakage syndrome(CLS)occurred in 2 patients(9%).Among these patients,5 patients completed the whole 5 treatment cycles,and the evaluation results were:1 patient's condition improved significantly,2 patients'condition was stable without progression,1 patient's lesion was slightly smaller than before,and 1 patient relapsed.Conclusion:anti-GD-2 immunotherapy has good safety and nuclear tolerance in pediatric neuroblastoma,and it's long-term efficacy needs further follow-up evaluation.