抗癌單株抗體相關輸注不良反應之探討

Infusion Reactions to Anti-cancer Monoclonal Antibodies Therapy

10.3966/168395442015121502003

王怡凱(Yi-Kai Wang)；謝麗鳳(Lie-Feng Hsieh)

單株抗體 ； 輸注不良反應 ； Monoclonal antibodies ； Infusion reactions

腫瘤護理雜誌

15卷2期（2015 / 12 / 01）

29 - 36

繁體中文

單株抗體已廣泛用於輔助各式癌症治療上，且扮演很重要的角色，儘管大多數單株抗體引起的輸注不良反應較輕微，仍有部分單株抗體會引起嚴重的輸注不良反應，可能危及生命。單株抗體引起輸注不良反應的確切機轉尚不清楚，可能是人類抗體與單株抗體間相互作用的結果。常見輸注不良反應包括：發燒、發抖、紅疹、血壓改變、呼吸急促、胸部不適、背痛或腹痛、噁心及腹瀉等症狀。嚴重的輸注不良反應常與系統性或全身性過敏反應有關，嚴重的輸注不良反應包括：血管性水腫、胸部緊迫感、昏倒、心搏過速及腹部絞痛等症狀。與輸注的速度及病人疾病有關，嚴格執行單株抗體輸注配製規定，且確實遵照輸注不良反應處理原則來處置及減緩患者不適感，加上即時監測相關症狀，可避免病情惡化，保障病人用藥安全。

Monoclonal antibodies represent a significant addition to therapeutic targets in human malignancies. Many of the agents share the risk of infusion reactions, most of which occur with the first dose. The majority of the reactions are mild or moderate and not life threatening, but severe ones could be fatal if not managed appropriately. The most common signs and symptoms of infusion reactions are fever, shaking chills, itching, alterations in blood pressure, chest discomfort and diarrhea. The serious reactions, such as angioedema, chest tightness, tachycardia, loss of consciousness, and abdominal cramping are mostly associated with the rate of infusion and patient disease. Better understanding of the infusion reactions and the general principles of prevention, treatment and monitoring of individual monoclonal antibodies can minimize the risks of infusion reactions and enhance medication safety.

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