临床儿科杂志 ›› 2022, Vol. 40 ›› Issue (1): 1-.doi: 10.12372/jcp.2022.21e1679

• 专家笔谈 •    下一篇

PD-1/PD-L1 抑制剂在儿童复发难治淋巴瘤中的免疫治疗进展

乔晓红   

  1. 同济大学附属同济医院儿科(上海 200065)
  • 出版日期:2022-01-15 发布日期:2022-01-11

The immunotherapy progress of PD-1/PD-L1 inhibitors in children with refractory lymphoma

QIAO Xiaohong   

  1. Department of Pediatrics, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, China
  • Online:2022-01-15 Published:2022-01-11

摘要: 一些临床研究中显示,以程序性细胞凋亡蛋白- 1(PD-1)或程序性凋亡配体- 1(PD-L1)为靶点的免疫检 查点抑制剂对于难治复发儿童恶性血液疾病及肿瘤有一定疗效,对难治复发霍奇金淋巴瘤、原发性纵隔B细胞淋巴瘤 有一定抗肿瘤作用,儿童和青少年耐受性相对良好。PD- 1 /PD-L 1抑制剂似乎并未增加感染率,但对于补充糖皮质激 素和/或TNF-α靶向药物免疫抑制治疗者建议使用卡氏肺囊虫预防措施。与其他类型免疫检查点抑制剂、化疗药物及 组蛋白脱乙酰酶抑制剂的联合应用,目前仍处于临床研究阶段。PD- 1 /PD-L 1抑制剂的儿童使用剂量、疗程及方案还 需要多中心的进一步研究,是否能够达到持久抗肿瘤作用亦需要更深入的研究。

关键词: 程序性细胞凋亡蛋白- 1; 程序性凋亡配体- 1; 淋巴瘤; 儿童

Abstract: Immune checkpoint inhibitors targeting programmed cell death protein- 1 (PD- 1 ) or programmed death ligand-1 (PD-L1) have shown certain efficacy in some clinical studies for refractory and recurrent children's malignant blood diseases and tumors. It has certain anti-tumor effect on refractory and recurrent Hodgkin lymphoma and primary mediastinal B-cell lymphoma, and is relatively well tolerated in children and adolescents. PD-1/PD-L1 inhibitors do not seem to increase the infection rate, but for glucocorticoid and/or TNF supplementation-伪 targeted drug immunosuppressive therapy suggests the use of preventive measures against Pneumocystis carinii. The combination of PD- 1 /PD-L 1 inhibitors with other types of immune checkpoint inhibitors, chemotherapy agents and histone deacetylase inhibitors is still in the clinical research stage. The dosage, course of treatment and scheme of PD- 1 /PD-L 1 inhibitors for children still need further research in multiple centers. Whether they can achieve lasting antitumor effect also needs further research.

Key words: programmed cell death protein-1 ; programmed death ligand-1 ; lymphoma; child