卡瑞利珠单抗联合挽救化疗方案治疗复发/难治性霍奇金淋巴瘤患儿的疗效和安全性评价  

Evaluation of efficacy and safety of camrelizumab combined with salvage chemotherapy in treatment of children with relapsed/refractory Hodgkin lymphoma

作　　者：岳福平 陈欣[1] 吴剑蓉[1] 何思佳 郭霞[1] 高举[1] 何国倩 Yue Fuping;Chen Xin;Wu Jianrong;He Sijia;Guo Xia;Gao Ju;He Guoqian(Department of Pediatric Hematology-Oncology,Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University),Ministry of Education,West China Second University Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川大学华西第二医院儿童血液肿瘤科,出生缺陷与相关妇儿疾病教育部重点实验室(四川大学),成都610041

出　　处：《国际输血及血液学杂志》2024年第6期480-487,共8页International Journal of Blood Transfusion and Hematology

基　　金：四川省抗癌协会2022年(齐鲁)科研资金专项科研课题(XH2022-507)。

摘　　要：目的探讨卡瑞利珠单抗联合挽救化疗方案对儿童复发/难治性霍奇金淋巴瘤(R/R HL)的疗效和安全性。方法选择2021年4月至2024年6月于四川大学华西第二医院血液科肿瘤诊治的3例R/R HL患儿研究对象。按入院时间将其编号为患儿1~3。采用回顾性研究方法,收集患儿的基本临床资料、治疗方法,分析并总结卡瑞利珠单抗联合挽救化疗方案治疗R/R HL患儿的疗效、预后及不良反应。对3例患儿的随访截至2024年6月1日。本研究遵循的程序符合四川大学华西第二医院医学伦理委员会制订的标准,并且经过该伦理委员会批准[批准文号:医学科研2024伦审批第(009)号],并与患者及监护人签订临床研究知情同意书。结果①本组3例R/R HL患儿中,男性患儿为2例,女性为1例,发病年龄分别为6.3、5.3、6.9岁。3例患儿初诊时病理类型均为混合细胞型,临床分期为ⅢA~B期,中、高危组,EB病毒(EBV)核酸检测呈阳性,既往均完成6个疗程化疗,复发时受累淋巴结区域>3个、乳酸脱氢酶水平升高、伴B症状、结外器官受累和EBV-DNA转阳。②2个疗程治疗后,获得完全缓解(CR)患儿为2例,部分缓解(PR)为1例。③截至末次随访,本组3例R/R HL患儿的生存期分别为37.1、38.5、34.5个月。患儿2、3处于持续CR状态,后续接受放疗和自体造血干细胞移植(auto-HSCT)。患儿1发生疾病进展,转化为弥漫大B细胞淋巴瘤伴EBV感染。④本组3例R/R HL患儿均发生Ⅲ~Ⅳ级不良反应,主要为血液学不良反应和感染。发生甲状腺功能减退患儿为1例。无患儿发生输液反应、神经毒性及反应性皮肤毛细血管增生症(RCCEP)等。结论卡瑞利珠单抗联合挽救化疗方案治疗R/R HL患儿具有良好效果,治疗不良反应可被患儿耐受。Objective To investigate the efficacy and safety of camelizumab combined with salvage chemotherapy in children with relapsed/refractory Hodgkin lymphoma(R/R HL).Methods From April 2021 to June 2024,a total of 3 children with R/R HL who were diagnosed and treated in the Hematology-Oncology Department of West China Second Hospital of Sichuan University were selected as the research subjects.Children were numbered 1 to 3 according to their admission time.A retrospective study method was used to collect the basic clinical data and treatment methods of the children,and their efficacy,prognosis and adverse reactions of camrelizumab combined with salvage chemotherapy regimen in treatment of children with R/R HL were analyzed and summarized.The procedures followed in this study conformed to the standards set by the Ethics Committee of the West China Second Hospital of Sichuan University and were approved by this ethics committee[Approval No.Medical Research 2024 Ethics Approval(009)],and informed consent signed by all children′s guardians.Results①Among the 3 R/R HL children in this group,2 were male and 1 was female.Their ages of onset were 6.3,5.3,and 6.9 years old respectively.At the initial diagnosis,the pathological type of these children was mixed cell type,the clinical stage was stageⅢA-B with intermediate and high risk group,Epstein-Barr virus(EBV)test was positive.All of them had completed 6 courses of chemotherapy.At the time of relapse,the number of affected lymph nodes areas was more than 3,lactate dehydrogenase level was elevated,B symptoms were present,extranodal organs were involved,and EBV-DNA turned positive.②After 2 courses of treatment,2 children achieved complete remission(CR)and 1 child achieved partial remission(PR).③As of the last follow-up,the survival time of the 3 R/R HL children in this group was 37.1,38.5 and 34.5 months,respectively.Child 2 and 3 maintained a continuous CR state and subsequently received radiotherapy and autologous stem cell transplantation(auto-HSCT).Child 1 had dis

关 键 词：霍奇金病 复发 程序性细胞死亡受体1 挽救疗法 治疗结果 预后 卡瑞利珠单抗 儿童 

分 类 号：R733.1[医药卫生—肿瘤]