CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题：Agents contributing to secondary immunodeficiency development in patients with multiple myeloma, chronic lymphocytic leukemia and non-Hodgkin lymphoma: A systematic literature review.
Agents contributing to secondary immunodeficiency development in patients with multiple myeloma, chronic lymphocytic leukemia and non-Hodgkin lymphoma: A systematic literature review.
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本综述强调了导致感染和中性粒细胞减少的癌症治疗可能与 SID 相关，并显示在 HM 治疗前及治疗期间低丙种球蛋白血症和淋巴细胞减少存在报告不足。
2022年3月通过PubMed开展系统性文献检索，寻找标题和/或摘要提及CLL、MM或NHL相关临床试验的文献，治疗药物涵盖12类：B细胞谱系单克隆抗体、CAR-T 疗法、蛋白酶体抑制剂、激酶抑制剂、免疫调节剂、抗代谢药、抗肿瘤抗生素、烷化剂、Bcl-2拮抗剂、组蛋白去乙酰化酶抑制剂、长春碱类和核输出选择性抑制剂。纳入文献须至少报告以下一项：任意级别和/或3级感染患者比例、任意级别和/或3级中性粒细胞减少患者比例，或低丙种球蛋白血症。研究还从相关文献中提取淋巴细胞减少以及特定感染类型（真菌、病毒、细菌、上/下呼吸道感染、支气管炎、肺炎、尿路感染、皮肤感染、胃肠道感染和脓毒症）的患者比例。
89项相关研究中，17项纳入CLL患者，38项纳入MM患者，34项纳入NHL患者。CLL、MM和NHL患者中，任意级别感染发生率分别为51.3%、35.9%和31.1%，任意级别中性粒细胞减少发生率分别为36.3%、36.4%和35.4%。按药物类别分析，3级感染比例最高的方案分别为：接受B细胞谱系单克隆抗体联合方案的MM患者中占41.0%，以及接受激酶抑制剂联合方案的CLL和NHL患者中分别占29.9%和38.0%。少数研究报告的淋巴细胞减少平均比例，在CLL、MM和NHL患者中分别为1.9%、11.9%和38.6%。仅有两项研究报告低丙种球蛋白血症患者比例：CLL为0–15.3%，NHL为5.9%；没有研究报告MM患者的低丙种球蛋白血症。
本综述指出了可能与SID相关、会导致感染和中性粒细胞减少的癌症治疗，并显示HM治疗前及治疗期间低丙种球蛋白血症和淋巴细胞减少存在报告不足。
A systematic literature search was performed in 03/2022 using PubMed to search for clinical trials that mentioned in the title and/or abstract selected cancer (CLL, MM, or NHL) treatments covering 12 classes of drugs, including B-lineage monoclonal antibodies, CAR T therapies, proteasome inhibitors, kinase inhibitors, immunomodulators, antimetabolites, anti-tumor antibiotics, alkylating agents, Bcl-2 antagonists, histone deacetylase inhibitors, vinca alkaloids, and selective inhibitors of nuclear export. To be included, a publication had to report at least one of the following: percentages of patients with any grade and/or grade 3 infections, any grade and/or grade 3 neutropenia, or hypogammaglobulinemia. From the relevant publications, the percentages of patients with lymphocytopenia and specific types of infection (fungal, viral, bacterial, respiratory [upper or lower respiratory tract], bronchitis, pneumonia, urinary tract infection, skin, gastrointestinal, and sepsis) were collected.
Of 89 relevant studies, 17, 38, and 34 included patients with CLL, MM, and NHL, respectively. In CLL, MM, and NHL, any grade infections were seen in 51.3%, 35.9% and 31.1% of patients, and any grade neutropenia in 36.3%, 36.4%, and 35.4% of patients, respectively. The highest proportion of patients with grade 3 infections across classes of drugs were: 41.0% in patients with MM treated with a B-lineage monoclonal antibody combination; and 29.9% and 38.0% of patients with CLL and NHL treated with a kinase inhibitor combination, respectively. In the limited studies, the mean percentage of patients with lymphocytopenia was 1.9%, 11.9%, and 38.6% in CLL, MM, and NHL, respectively. Two studies reported the proportion of patients with hypogammaglobulinemia: 0-15.3% in CLL and 5.9% in NHL (no studies reported hypogammaglobulinemia in MM).
This review highlights cancer treatments contributing to infections and neutropenia, potentially related to SID, and shows underreporting of hypogammaglobulinemia and lymphocytopenia before and during HM therapies.
在 PubMed 查看 → 出版商原文（DOI） 全文 PDF（PMC）· 可下载 治疗专题与资料阅读指南 资料来源与翻译说明 报告译文或资料问题 →
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