clinicaloncologyКлинический случай в онкологииClinical Case in Oncology3034-14773034-4018ОНКОПРАКТИК10.62546/3034-1477-2024-2-1-23-29clinicaloncology-21Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙCLINICAL CASEСложности дифференциальной диагностики гематологической токсичности на фоне терапии ингибиторами контрольных точек иммунного ответаDifficulties in differential diagnosis of hematological toxicity during therapy with immune checkpoint inhibitorshttps://orcid.org/0000-0003-4447-9458ОрловаР. В.OrlovaR. V.

Орлова Рашида Вахидовна — 3.1.6, доктор медицинских наук, профессор, заведующий кафедрой онкологии;  главный специалист по  клинической онкологии

199106, Санкт-Петербург, 21-линия В.О., д.  8а; 198255, Санкт-Петербург, пр.  Ветеранов, д. 56

Orlova Rashida Vakhidovna — Doctor of Medical Sciences, Prof., Head. Department of Oncology; Ch. clinical oncology specialist, City Clinical Oncology Centre

St. Petersburg

orlova_rashida@mail.ruhttps://orcid.org/0000-0003-2003-7938АвраменкоИ. В.AvramenkoI. V.

Авраменко Инна Владимировна — заведующий клинико-аналитическим отделом, врач-онколог отделения противоопухолевой лекарственной терапии № 12; 

198255, Санкт-Петербург, пр.  Ветеранов, д. 56

Avramenko Inna Vladimirovna  — Head of Clinical and Analytical Department, medical oncologist of Cancer Drug Therapy (Chemotherapeutic) Dept No. 12

St. Petersburg

inna_avramenko08@mail.ruФГБОУ ВО «Санкт-Петербургский государственный университет»; СПб ГБУЗ «Городской клинический онкологический диспансер»РоссияSt. Petersburg State University; City Clinical Oncology DispensaryRussian FederationСПб ГБУЗ «Городской клинический онкологический диспансер»РоссияCity Clinical Oncology DispensaryRussian Federation202421062024212329Copyright © Орлова Р.В., Авраменко И.В., 20242024Орлова Р.В., Авраменко И.В.Orlova R.V., Avramenko I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncocase.ru/jour/article/view/21

Ингибиторы контрольных точек иммунного ответа кардинально изменили подход в онкологии и стали новым стандартом лечения многих солидных опухолей, значительно увеличив продолжительность жизни больных. С  появлением нового класса препаратов мы столкнулись с  совершенно уникальным профилем токсичности. Спектр воздействия влияет на разнообразные проявления, которые затрагивают почти каждый орган и систему организма. Чаще всего поражаются кожа, железы внутренней секреции, желудочно-кишечный тракт, легкие, печень. Реже проявляются осложнения со стороны мочевыделительной, сердечно-сосудистой, мышечно-суставной, нервной и кроветворной систем. В данной статье рассмотрено одно из редких осложнений, которое возникает на фоне терапии ингибиторами контрольных точек иммунного ответа — тромбоцитопения с геморрагическим синдромом. Основная цель статьи  — повысить клиническую настороженность и  подчеркнуть актуальность проблемы редких осложнений на фоне иммунотерапии.

Checkpoint inhibitors have radically changed the approach to oncology and have become the new standard of treatment for many solid tumors, significantly increasing the life expectancy of patients. With the advent of a new class of drugs, we are faced with a completely recognized toxicity profile. The spectrum affects other manifestations that affect almost every organ and system of the body. Most often the skin, the secretion of the internal gland, the gastrointestinal tract, lungs, and liver are affected. Complications from the urinary, cardiovascular, muscular-articular, nervous and hematopoietic systems occur less frequently. This article will discuss one of the rare complications that occurs during therapy with checkpoint inhibitors — thrombocytopenia with hemorrhagic syndrome. The main purpose of the article is to increase clinical alertness and highlight the relevance of the problem of rare complications during immunotherapy.

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The authors declare that there are no conflicts of interest present.