替雷利珠单抗致噬血细胞综合征  

Hemophagocytic lymphohistiocytosis caused by tislelizumab

作　　者：李安霞 薛淑一 赵冰清[1] 平耀东[1] Li Anxia;Xue Shuyi;Zhao Bingqing;Ping Yaodong(Department of Pharmacy,Peking University Cancer Hospital&Institute,Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Beijing 100142,China;Department of Pharmacy,Sanya Central Hospital(Hainan Third People′s Hospital),Hainan Province,Sanya 572019,China;Department of Pharmacy,Qingdao Central Hospital,Shandong Province,Qingdao 266042,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所药剂科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142 [2]三亚中心医院(海南省第三人民医院)药学部,三亚572032 [3]青岛市中心医院药学部,青岛266042

出　　处：《药物不良反应杂志》2023年第11期700-702,共3页Adverse Drug Reactions Journal

摘　　要：1例49岁男性因原发性肝细胞癌接受替雷利珠单抗联合多纳非尼治疗。2个周期后(第1次用药后37 d),患者出现持续发热,纳差、乏力,白细胞、血红蛋白、血小板减少,纤维蛋白原降低,血清铁蛋白显著升高(91501μg/L),脾脏增大,临床诊断为噬血细胞综合征,考虑为替雷利珠单抗所致。给予甲泼尼龙60 mg/d静脉滴注4 d,40 mg/d静脉滴注7 d,28 mg/d静脉滴注5 d,之后换为泼尼松35 mg/d口服治疗(4~6周内逐渐减量至停药)。治疗过程中,实验室检查各项指标逐渐好转。患者未再使用替雷利珠单抗,并恢复多纳非尼治疗,未再出现上述症状。A 49‑year‑old male patient with primary hepatocellular carcinoma was treated with donafenib combined with tislelizumab.After 2 cycles of treatments,he developed persistent fever,poor appetite,fatigue,decreased white blood cells,hemoglobin,platelets,and fibrinogen,and significant increase of serum ferritin(91501μg/L)and splenomegaly.Hemophagocytic lymphohistiocytosis was diagnosed,which was consideredto be caused by tislelizumab.He received intravenous infusion of methylprednisolone 60 mg/d for 4 days,40 mg/d for 7 days,28 mg/d for 5 days,and at last,oral prednisone 35 mg/d was given,with dose reduction to discontinuation within 4‑6 weeks.During the treatment,his laboratory tests results were improved.The patient did not use tislelizumab again and donafenib treatment was reused,and the above symptoms did not recur.

关 键 词：淋巴组织细胞增多症 嗜血细胞性 免疫检查点抑制剂 血清铁蛋白 替雷利珠单抗 免疫相关不良事件 

分 类 号：R979.1[医药卫生—药品]