Outcomes of programmed death protein-1 inhibitors treatment of chronic active Epstein Barr virus infection: A single center retrospective analysis.
Outcomes of programmed death protein-1 inhibitors treatment of chronic active Epstein Barr virus infection: A single center retrospective analysis.
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DOI：
10.3389/fimmu.2023.1093719
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发表时间：
2023
影响因子：
7.3
通讯作者：
Zheng, Miao
中科院分区：
文献类型：
--
作者：
Ma, Yaxian;Zhang, Peiling;Bao, Yuhan;Luo, Hui;Wang, Jiachen;Huang, Liang;Zheng, Miao
关键词：
慢性活动性EB病毒病（CAEBV）是一种以持续性传染性单核细胞增多症样症状为特征的高死亡率疾病。CAEBV没有标准治疗方法，异基因造血干细胞移植（HSCT）被认为是唯一潜在的治疗方法。PD-1抑制剂在许多EB病毒相关疾病中获得了高应答。在这项单中心回顾性分析中，我们报告了PD-1抑制剂治疗CAEBV的结局。回顾性分析了2017年6月1日至2021年12月31日期间在我中心接受PD-1抑制剂治疗的所有不伴噬血细胞性淋巴组织细胞增生症（HLH）的CAEBV患者。评价了PD-1抑制剂的疗效和安全性。在发病时中位年龄为33岁（范围：11-67岁）的16例患者中，12例患者对PD-1抑制剂有应答，中位无进展生存期（PFS）为11.1个月（范围：4.9-54.8个月）。3例达到临床完全缓解（临床CR），以及分子CR。5例患者达到并保持部分缓解（PR），4例从PR转为无缓解（NR）。对于3例CR患者，从首次应用PD-1抑制剂至临床CR的中位时间和周期为6周（范围，4-10周）和3个周期（范围，2-4个周期），在PD-1抑制剂输注的中位时间为16.7周（范围，6.1-18.4周）和5个周期（范围，3-6个周期）后达到分子CR。除1例患者发生免疫相关胰腺炎外，未观察到免疫相关不良事件。治疗结果与血细胞计数、肝功能、LDH、细胞因子或铁蛋白水平无关。NK细胞功能、肿瘤组织中的PD-L1表达和基因突变可能与治疗反应相关。对于CAEB病毒患者，PD-1抑制剂具有可耐受的毒性和相当的结果，同时改善生活质量和经济毒性。需要进行更大规模的前瞻性研究和更长的随访时间。
Chronic active Epstein-Barr virus (CAEBV) disease is a high-mortality disease, which is characterized by persistent infectious mononucleosis-like symptoms. There is no standard treatment for CAEBV and allogeneic hematopoietic stem cell transplantation (HSCT) was considered the only potentially therapeutic approach. PD-1 inhibitors have achieved high response in many Epstein-Barr virus-related diseases. In this single-center retrospective analysis, we report the outcomes of PD-1 inhibitors treatment of CAEBV. All CAEBV patients without hemophagocytic lymphohistiocytosis (HLH), who were treated with PD-1 inhibitors in our center between 6/1/2017 and 12/31/2021, were retrospectively analyzed. The efficacy and safety of the PD-1 inhibitors were evaluated. Among the sixteen patients with a median age at onset of 33 years (range, 11-67 years), twelve patients responded to PD-1 inhibitors and the median progression-free survival (PFS) was 11.1 months (range, 4.9-54.8 months). Three achieved clinical complete response (clinical CR), as well as molecular CR. Five patients achieved and remained partial response (PR), and four converted from PR to no response (NR). For three CR patients, the median time and cycles from the first application of PD-1 inhibitor to clinical CR were 6 weeks (range, 4-10 weeks) and 3 cycles (range, 2-4 cycles), and molecular CR was achieved after a median of 16.7 weeks (range, 6.1-18.4 weeks) and 5 cycles (range, 3-6 cycles) of PD-1 inhibitor infusion. No immune-related adverse events have been observed except for one patient who suffered immune-related pancreatitis. There was no correlation of treatment outcome with blood count, liver function, LDH, cytokine or ferritin levels. NK cell function, PD-L1 expression in tumor tissue and gene mutation possibly correlated with treatment response. In patients with CAEBV, PD-1 inhibitors have tolerable toxicity and comparable outcomes while improving quality of life and financial toxicity. Larger prospective studies and longer follow-up time is needed to be conducted.
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影响因子：
5.2
作者：
Fujiwara S;Nakamura H
通讯作者：
Nakamura H
T细胞共刺激和共抑制的分子机制。
DOI：
10.1038/nri3405
发表时间：
2013-04
期刊：
Nature reviews. Immunology
影响因子：
--
作者：
通讯作者：
--
PD-L1 通过 NF-kappa B 途径被 EBV 驱动的 LMP1 上调，并与自然杀伤/T 细胞淋巴瘤的不良预后相关
影响因子：
28.5
作者：
Bi XW;Wang H;Zhang WW;Wang JH;Liu WJ;Xia ZJ;Huang HQ;Jiang WQ;Zhang YJ;Wang L
通讯作者：
Wang L
影响因子：
20.3
作者：
Cohen, Jeffrey I.;Jaffe, Elaine S.;Straus, Stephen E.
通讯作者：
Straus, Stephen E.
抗 PD-1 抗体与 P-GEMOX 的组合作为晚期自然杀伤/T 细胞淋巴瘤的潜在有效免疫化疗
影响因子：
39.3
作者：
Cai J;Liu P;Huang H;Li Y;Ma S;Zhou H;Tian X;Zhang Y;Gao Y;Xia Y;Zhang X;Yang H;Li L;Cai Q
通讯作者：
Cai Q