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。

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.