文摘
摘要目的:报告的临床表现、治疗一系列神经ia和结果的情况。
背景:癌症治疗与免疫抑制剂(ICI)可以联想到检查站的几种不良事件(ia)可危及生命。
设计/方法:回顾性评估患者的神经ia的血清或脑脊液样本研究实验室(Jan2018-Sep2022)。临床信息是通过一个结构化的问卷。排除标准缺乏临床信息和其它原因造成的神经功能障碍的证据。治疗反应是评估一个月内症状出现,结果在最后的随访中。
结果:47例(29岁男性,62%),平均年龄67岁(iqr60 - 74)被包括在内。最常见的肺癌肿瘤(28日60%)和黑色素瘤(9 19%)。26例(55%)患者接受anti-PD1, 13 (28%) PDL-1, 8例(17%)。中位数时间神经ia 15周(IQR3-32)。最初的报告是:脑病(30例,64%)、肌无力(9 19%),共济失调(3 6%),视觉功能障碍(3 6%),和便秘(4%)。中位数夫人在最低点是4(3 - 5),7例(15%)患者所需的加护病房。Abs检测10 (21%;胡锦涛Ma2 = 3 = 2,, GFAP = 2, GABAbR = 1, GAD65 = 1, AQP4 = 1)。42(89%)治疗;所有收到的类固醇,17(36%)静脉注射免疫球蛋白,9(21%)其他免疫抑制剂。 Patients without early neurologic improvement (14, 30%) were more likely to be older, have lung cancer (p=0.01), and higher mRS at nadir (p=0.001) than those who improved. After a median follow-up of 107 days (45–356), mRS was 3 (0–6), and 26 (55%) patients had a poor outcome: 23 (49%) died (10 [21%] related to neurologic iAE) and the other 3 didn’t improve or worsened. Good outcome was associated with early neurologic improvement (p=0.001).
结论:在这种情况下与主导CNS ia系列,一半的患者临床疗效不佳,而在20%的神经是管理学院的死因。
披露:Elianet丰塞卡没有披露。卡布雷拉先生Maqueda没有披露。拉奎尔Ruiz-Garcia没有披露。博士Naranjo Rondan没有披露。布兰科博士Morgado没有披露。Dalmau博士已经收到个人薪酬在500 - 4999美元的范围作为顾问阿斯特拉研究所。Dalmau博士已经收到个人薪酬在500 - 4999美元的范围作为顾问詹森研发。Dalmau博士已经收到个人薪酬在10000 - 49999美元的范围作为一个编辑,副主编,或为美国神经病学学会编辑顾问委员会成员。首页立即家人Dalmau博士已收到个人薪酬在5000 - 9999美元的范围作为一个编辑,副主编,或编辑顾问委员会成员Springer自然。Dalmau博士的机构收到圣人疗法的研究支持。 The institution of Dr. Dalmau has received research support from Edmond J.Safra Foundation . The institution of Dr. Dalmau has received research support from La Caixa Foundation. The institution of Dr. Dalmau has received research support from Spanish Ministry of Health (ISCIII). The institution of Dr. Dalmau has received research support from Euroimmun, Inc. Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. An immediate family member of Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. An immediate family member of Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care. Dr. Graus has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink. Dr. Graus has received intellectual property interests from a discovery or technology relating to health care. The institution of Dr. Martinez-Hernandez has received research support from Instituto de Salud Carlos III. Dr. Martinez-Hernandez has received personal compensation in the range of $0-$499 for serving as a travel and speaking honoraria with Biogen. Dr. Martinez-Hernandez has received personal compensation in the range of $0-$499 for serving as a travel honoraria with UCB.
