PMID- 32762232
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 2224-5839 (Electronic)
IS  - 2224-5820 (Linking)
VI  - 9
IP  - 4
DP  - 2020 Jul
TI  - An esophageal cancer case of cytokine release syndrome with multiple-organ injury 
      induced by an anti-PD-1 drug: a case report.
PG  - 2393-2399
LID - 10.21037/apm-20-1310 [doi]
AB  - When anti-PD-1 drugs target healthy tissues, it may cause immune-related adverse 
      events (irAEs). Hematological toxicities and renal immune-related adverse 
      reactions were rare; these events recorded were often clinically severe and 
      life-threatening. In this study, we first reported on an elderly esophageal 
      cancer (ESC) case of cytokine release syndrome (CRS) and irAEs induced by 
      radiotherapy following anti-PD-1 drug treatment. A 69-year-old male patient with 
      ESC was hospitalized on December 2, 2019, after three cycles of chemotherapy with 
      docetaxel and nedaplatin accompanied by the addition of PD-1 inhibitor 
      (Sintilimab). The chemotherapy scheme was interrupted due to the absence of any 
      response. Instead, three-dimensional conformal radiotherapy (60 Gy/30 times, 5 
      times/week) was locally applied to treat the esophageal lesion. Typical CRS and 
      irAEs, including mild diarrhea, intermittent low fever, and leukopenia, occurred 
      after 6 times of radiotherapy, which was alleviated by symptomatic treatment. 
      Such radiotherapy, however, encountered an unexpected early ending after 10 times 
      with patient platelet level being significantly decreased to 31x109/L and the 
      serum creatinine of the patients sharply increased from 78.4 to 609.5 micromol/L. CT 
      scan presented scattered inflammation in both lung. It also showed that 
      mediastinal lymph nodes and esophageal lesions were significantly reduced, and 
      the patients received symptomatic treatment of glucocorticoids and other 
      immunomodulators. The patient get discharged from the hospital after the 
      combination treatment improved the irAEs symptoms. This paper showed the 
      possibility of CRS and multiple-organ injuries as potential irAEs during 
      radiotherapy following the anti-PD-1 therapy strategy and discussed the 
      management of these adverse events (AEs).
FAU - Gao, Chao
AU  - Gao C
AD  - Department of Radiation Oncology, The Fourth Hospital of Hebei Medical 
      University, Shijiazhuang, China.
FAU - Xu, Jinsheng
AU  - Xu J
AD  - Department of Nephrology, The Fourth Hospital of Hebei Medical University, 
      Shijiazhuang, China.
FAU - Han, Chun
AU  - Han C
AD  - Department of Radiation Oncology, The Fourth Hospital of Hebei Medical 
      University, Shijiazhuang, China.
FAU - Wang, Lan
AU  - Wang L
AD  - Department of Radiation Oncology, The Fourth Hospital of Hebei Medical 
      University, Shijiazhuang, China.
FAU - Zhou, Wei
AU  - Zhou W
AD  - Department of Nephrology, The Fourth Hospital of Hebei Medical University, 
      Shijiazhuang, China.
FAU - Yu, Qiyao
AU  - Yu Q
AD  - Department of Research, The Fourth Hospital of Hebei Medical University, 
      Shijiazhuang, China. yumnn9@163.com.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - China
TA  - Ann Palliat Med
JT  - Annals of palliative medicine
JID - 101585484
RN  - 0 (Pharmaceutical Preparations)
SB  - IM
MH  - Aged
MH  - Cytokine Release Syndrome
MH  - *Esophageal Neoplasms/drug therapy
MH  - Humans
MH  - Male
MH  - *Pharmaceutical Preparations
OTO - NOTNLM
OT  - Esophageal cancer (ESC)
OT  - PD-1;
OT  - cytokine release syndrome (CRS)
OT  - immune-related adverse events (irAEs)
OT  - multiple-organ injury
EDAT- 2020/08/09 06:00
MHDA- 2021/05/15 06:00
CRDT- 2020/08/09 06:00
PHST- 2020/05/26 00:00 [received]
PHST- 2020/07/15 00:00 [accepted]
PHST- 2020/08/09 06:00 [entrez]
PHST- 2020/08/09 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
AID - 10.21037/apm-20-1310 [doi]
PST - ppublish
SO  - Ann Palliat Med. 2020 Jul;9(4):2393-2399. doi: 10.21037/apm-20-1310.