Oana Diana Preda, S. Badelita, I. Ursuleac, R. Irimia, Sonia Balanica, Monica Cojocaru, Cristina Cotruta, C. Dobrea, Daniel Coriu
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引用次数: 0
摘要
背景:布伦妥昔单抗韦多汀(BV)彻底改变了霍奇金淋巴瘤的治疗格局,但它对原有自身免疫性疾病的影响仍然难以捉摸。方法:在此,我们介绍了四例同时患有自身免疫性疾病--克罗恩病、白癜风、I型糖尿病和微小病变--并接受BV治疗的霍奇金淋巴瘤患者。这些患者由于疾病处于晚期且 IPI 评分较高,因此接受了 A-AVD 而非 ABVD 治疗。结果:我们的研究结果揭示了 BV 暴露与自身免疫表现之间惊人而复杂的相互作用,强调了多学科合作管理患者的必要性。值得注意的是,在前三个病例中观察到了自身免疫症状的加重,其中以 T 细胞介导的自身免疫为主。此外,白癜风患者接触 BV 会诱发自身免疫性血小板减少症,这突出表明免疫调节功能受到严重破坏。相反,在以 B 细胞和 T 细胞介导的免疫混合为特征的微小变化病例中,结果却很好。结论:本文强调了在同时患有自身免疫性疾病的患者中警惕BV诱发自身免疫性疾病发作的极端重要性,为量身定制的患者护理提供了启示。
Complications of Brentuximab Therapy in Patients with Hodgkin’s Lymphoma and Concurrent Autoimmune Pathology—A Case Series
Background: Brentuximab Vedotin (BV) has revolutionized the treatment landscape for Hodgkin’s lymphoma, yet its effects on pre-existing autoimmune disorders remain elusive. Methods: Here, we present four cases of patients with concurrent autoimmune conditions—Crohn’s disease, vitiligo, type I diabetes, and minimal change disease—undergoing BV therapy for Hodgkin’s lymphoma. The patients were treated with A-AVD instead of ABVD due to advanced-stage disease with high IPI scores. Results: Our findings reveal the surprising and complex interplay between BV exposure and autoimmune manifestations, highlighting the need for multidisciplinary collaboration in patient management. Notably, the exacerbation of autoimmune symptoms was observed in the first three cases where T-cell-mediated autoimmunity predominated. Additionally, BV exposure precipitated autoimmune thrombocytopenia in the vitiligo patient, underscoring the profound disruptions in immune regulation. Conversely, in the minimal change disease case, a disease characterized by a blend of B- and T-cell-mediated immunity, the outcome was favorable. Conclusions: This paper underscores the critical importance of vigilance toward autoimmune flare-ups induced by BV in patients with concurrent autoimmune conditions, offering insights for tailored patient care.
期刊介绍:
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.