帕博利珠单抗致再生障碍性贫血/纯红细胞再生障碍性贫血的文献分析  

Literature analysis of aplastic anemia/pure red cell aplasia induced by pembrolizumab

作　　者：李悦 张诗超[1] 谢诚[1] 朱建国[1] 李芸[1] LI Yue;ZHANG Shichao;XIE Cheng;ZHU Jianguo;LI Yun(Dept.of Pharmacy,the First Affiliated Hospital of Soochow University,Jiangsu Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院药学部,江苏苏州215000

出　　处：《中国药房》2025年第6期737-741,共5页China Pharmacy

基　　金：江苏省老年医学学会2023年度临床药学专项基金科研项目(No.JGS2023ZDYX009)。

摘　　要：目的分析帕博利珠单抗致再生障碍性贫血(AA)/纯红细胞再生障碍性贫血(PRCA)的临床特征,为临床安全用药提供参考。方法以“帕博利珠单抗”“贫血”“再生障碍性贫血”“pembrolizumab”“keytruda”“anemia”等为中英文检索词,检索PubMed、Embase、中国知网、万方数据和维普网,收集帕博利珠单抗致AA/PRCA的相关文献并进行描述性统计分析。结果共纳入10篇文献,共计10例患者。10例患者中,男性5例、女性5例,65岁以上有5例;原患疾病以转移性黑色素瘤为主(4例);AA/PRCA的发生时间为帕博利珠单抗第1次用药后13 d~3年,临床表现主要包括疲劳、呼吸急促、口腔/鼻出血、全身紫癜等,其中8例患者出现中度贫血,2例患者出现重度贫血。经停药并予以治疗后,5例患者好转,1例患者贫血加重,4例患者死亡。结论临床应用帕博利珠单抗时应定期监测血常规,出现AA/PRCA等相关症状时,应及时停药并根据患者具体情况进行对症治疗,以保障患者的用药安全。OBJECTIVE To analyze the clinical characteristics of aplastic anemia(AA)/pure red cell aplasia(PRCA)induced by pembrolizumab,and provide reference for clinical safe drug use.METHODS Using search terms as“pembrolizumab”,“keytruda”,“anemia”and“aplastic anemia”in both Chinese and English,the literature related to AA/PRCA induced by pembrolizumab were retrieved from PubMed,Embase,CNKI,Wanfang and VIP databases,and then analyzed descriptively and statistically.RESULTS A total of 10 patients were included from 10 literature;among these 10 patients,there were 5 males and 5 females,with 5 patients being aged 65 or above.The primary disease was mainly metastatic melanoma(4 cases).AA/PRCA occurred 13 d-3 years after the first dose of pembrolizumab.The main clinical manifestations included fatigue,dyspnea,oral/nasal bleeding,diffuse purpura,etc.;8 cases developed moderate anemia and 2 cases developed severe anemia.After discontinuation and receiving supportive therapy,5 cases improved,1 case worsened in anemia,and 4 cases died.CONCLUSIONS When using pembrolizumab in clinical practice,blood routine should be regularly monitored.When AA/PRCA and other related symptoms occur,pembrolizumab should be stopped in time and a therapy regimen should be formulated according to the patient’condition,to ensure the safety of medication.

关 键 词：帕博利珠单抗 再生障碍性贫血 纯红细胞再生障碍性贫血 文献分析 

分 类 号：R979.1[医药卫生—药品] R556.5[医药卫生—药学]