抗 PD-1 治疗相关 1 型糖尿病在复发经典霍奇金淋巴瘤的儿科患者中。
Anti-PD-1 Therapy-Associated Type 1 Diabetes in a Pediatric Patient With Relapsed Classical Hodgkin Lymphoma.
机构信息
Department of Clinical Diabetes, Endocrinology & Metabolism, Diabetes & Metabolism Research Institute, City of Hope, Duarte, CA
Diabetes & Metabolism Research Institute, Beckman Research Institute, City of Hope, Duarte, CA.
出版信息
Diabetes Care. 2020 Sep;43(9):2293-2295. doi: 10.2337/dc20-0740. Epub 2020 Jul 2.
OBJECTIVE
Immune checkpoint inhibitors (ICIs) perturb T-cell regulatory pathways to enhance antitumor immunity. However, an increase reporting of ICI-associated diabetes is observed in adults. To our knowledge, no cases have been reported in the pediatric population.
RESEARCH DESIGN AND METHODS
We describe a pediatric case of ICI-associated type 1 diabetes in a 12-year-old Hispanic boy with Hodgkin lymphoma. The patient had a history of autologous hematopoietic stem cell transplantation and was treated with pembrolizumab after disease progression.
RESULTS
The patient was admitted for diabetic ketoacidosis after five cycles of pembrolizumab. The patient was discharged with daily insulin injections and has continued on exogenous insulin ever since.
CONCLUSIONS
The expanded ICI use may lead to more cases in pediatric patients as has been observed in adults. Considering the acute manifestation of diabetes and the added burden of lifelong insulin therapy, in particular for pediatric patients and their families, monitoring and education of ICI-associated diabetes in children is needed.
目的
免疫检查点抑制剂（ICI）扰乱 T 细胞调节途径，增强抗肿瘤免疫。然而，在成年人中观察到与 ICI 相关的糖尿病报告增加。据我们所知，在儿科人群中尚未有报道。
研究设计和方法
我们描述了一例 12 岁西班牙裔男孩霍奇金淋巴瘤患者接受 ICI 相关 1 型糖尿病的病例。该患者有自体造血干细胞移植史，在疾病进展后接受了 pembrolizumab 治疗。
结果
该患者在接受 pembrolizumab 五个周期后因糖尿病酮症酸中毒入院。患者出院后每天注射胰岛素，此后一直持续使用外源性胰岛素。
结论
随着 ICI 在成人中的广泛应用，可能会导致儿科患者中出现更多病例。鉴于糖尿病的急性表现和终身胰岛素治疗的额外负担，特别是对于儿科患者及其家庭，需要对儿童的 ICI 相关糖尿病进行监测和教育。
Zotero 插件