تقرير
Case Report: Initial Treatment Adjustments and Complications in Ovarian Cancer Patient With Inborn Error of Immunity.
| العنوان: | Case Report: Initial Treatment Adjustments and Complications in Ovarian Cancer Patient With Inborn Error of Immunity. |
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| المؤلفون: | Mammadova J; Morsani College of Medicine, University of South Florida, Tampa, FL, United States., Redden A; Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States., Cruz R; Morsani College of Medicine, University of South Florida, Tampa, FL, United States., Ujhazi; Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, United States., Ellison M; Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, United States., Gatewood T; Department of Pharmacy at Gynecologic and Neuro Oncology Clinics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States., Duff C; Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, United States., Canella A; Division of Infectious Disease and International Medicine, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States., Somboonwit C; Division of Infectious Disease and International Medicine, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States., Sriaroon C; Division of Infectious Disease and International Medicine, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States., Dasso JF; Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, United States., Harville T; Division of Hematology, Department of Pathology and Laboratory Services, and Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States., Ismail-Khan R; Department of Cardio-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States., Walter JE; Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, United States., Gordon S; Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, United States. |
| المصدر: | Frontiers in oncology [Front Oncol] 2022 Jun 29; Vol. 12, pp. 843741. Date of Electronic Publication: 2022 Jun 29 (Print Publication: 2022). |
| نوع المنشور: | Case Reports |
| اللغة: | English |
| بيانات الدورية: | Publisher: Frontiers Research Foundation] Country of Publication: Switzerland NLM ID: 101568867 Publication Model: eCollection Cited Medium: Print ISSN: 2234-943X (Print) Linking ISSN: 2234943X NLM ISO Abbreviation: Front Oncol Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [Lausanne : Frontiers Research Foundation] |
| مستخلص: | Background: Patients with inborn errors of immunity (IEI) have increased risk of developing cancers secondary to impaired anti-tumor immunity. Treatment of patients with IEI and cancer is challenging as chemotherapy can exacerbate infectious susceptibility. However, the literature on optimal cancer treatment in the setting of IEI is sparse. Objectives: We present a patient with specific antibody deficiency with normal immunoglobins (SADNI), immune dysregulation (ID), and stage III ovarian carcinoma as an example of the need to modify conventional treatment in the context of malignancy, IEI, and ongoing infections. Methods: This is a retrospective chart review of the patient's clinical manifestations, laboratory evaluation and treatment course. Results: Our patient is a female with SADNI and ID diagnosed with stage III ovarian carcinoma at 60 years of age. Her ID accounted for antinuclear antibody positive (ANA+) mixed connective tissue diseases, polyarthralgia, autoimmune neutropenia, asthma, autoimmune thyroiditis, and Celiac disease. Due to the lack of precedent in the literature, her treatment was modified with continuous input from infectious disease, allergy/immunology and oncology specialist using a multidisciplinary approach.The patient completed debulking surgery and 6 cycles of chemotherapy. The dosing for immunoglobulin replacement therapy was increased for prophylaxis. Chemotherapy doses were lowered for all cycles preemptively for IEI. The therapy included carboplatin, paclitaxel, bevacizumab, and pegfilgrastim. The patient completed six-months of maintenance medication involving bevacizumab.Her treatment course was complicated by Mycobacterium avium-complex (MAC) infection, elevated bilirubin and liver enzymes attributed to excessive immunoglobulin replacement therapy, and urinary tract infection (UTI) and incontinence.Cancer genetic analysis revealed no targetable markers and primary immunodeficiency gene panel of 407 genes by Invitae was unrevealing. Lab tests revealed no evidence of Epstein-Barr Virus (EBV) infection. Post-chemotherapy imaging revealed no evidence of cancer for 1 year and 4 months, but the disease relapsed subsequently. The patient's lung scarring requires vigilance. Conclusions: Our patient with ovarian cancer and IEI required modified treatment and prevention of complications. In cases of IEI, optimal chemotherapy should be titrated to minimize immunosuppression yet treat cancer aggressively while decreasing the risk of infection with prophylactic antibiotics and prolonged post-treatment surveillance, including pulmonary evaluation. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Mammadova, Redden, Cruz, Ellison, Gatewood, Duff, Canella, Somboonwit, Sriaroon, Dasso, Harville, Ismail-Khan and Walter.) |
| التعليقات: | Erratum in: Front Oncol. 2022 Sep 22;12:1007616. (PMID: 36226071) |
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| فهرسة مساهمة: | Keywords: antibody deficiency; case report; inborn error of immunity; ovarian cancer; primary immunodeficiency |
| تواريخ الأحداث: | Date Created: 20220718 Latest Revision: 20221017 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC9278814 |
| DOI: | 10.3389/fonc.2022.843741 |
| PMID: | 35847860 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2234-943X |
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| DOI: | 10.3389/fonc.2022.843741 |