利妥昔单抗治疗造血干细胞移植后血小板输注无效的临床疗效

doi:10.3969/j.issn.1000-8535.2018.06.003

广州医药 ›› 2018, Vol. 49 ›› Issue (6): 13-16.DOI: 10.3969/j.issn.1000-8535.2018.06.003

利妥昔单抗治疗造血干细胞移植后血小板输注无效的临床疗效

江和碧, 张晓红, 江华

广州市妇女儿童医疗中心血液肿瘤科（广州 510623）

收稿日期:2018-06-20 出版日期:2018-11-20 发布日期:2021-11-30
通讯作者: 江和碧,E-mail：jhbyay@sina.com

Efficiency of treatment with rituximab in platelet transfusion refractoriness after hematopoietic stem cell transplantation

JIANG Hebi, ZHANG Xiaohong, JIANG Hua

Department of Hematology and Oncology,Guangzhou Women and Children's Medical Center,Guangzhou 510623,China

Received:2018-06-20 Online:2018-11-20 Published:2021-11-30

摘要/Abstract

摘要： 目的观察利妥昔单抗在治疗造血干细胞移植后血小板输注无效的有效性和安全性。方法回顾分析我院2014年1月—2017年6月收治的11例利妥昔单抗治疗的造血干细胞移植后血小板输注无效的病例资料,其中包括重型地中海贫血8例,急性髓系白血病1例,重型再生障碍性贫血2例。结果 10例造血干细胞移植后血小板输注无效患者经利妥昔单抗治疗,375 mg/m²,每周1次,2~3次后血小板输注无效的状况明显改善;1例造血干细胞移植后血小板输注无效患者接受1次利妥昔单抗治疗,仍存在血小板输注无效,最终因颅内出血死亡。结论利妥昔单抗是治疗造血干细胞移植后血小板输注无效的一种很有效的治疗方法。

关键词: 血小板输注无效, 利妥昔单抗, 造血干细胞移植

Abstract: Objective The purpose of our study was to evaluate the efficacy and safety of rituximab in the treatment of platelet transfusion refractoriness after hematopoietic stem cell transplantation. Methods We retrospectively analyzed 11paitents （8 thalassemia major,2 sever aplastic anemia,and 1 acute myeloid leukemia） with platelet transfusion refractoriness after hematopoietic stem cell transplantation. All 11 patients received treatment of rituximab. Results 10 of 11 platelet transfusion refractoriness patients after hematopoietic stem cell transplantation had improvement of platelets transfusion,1 patient of 11 platelet transfusion refractoriness patients had no response and died of intracranial hemorrhage. Conclusion Rituximab is a promising treatment in patients with platelet transfusion refractoriness after hematopoietic stem cell transplantation.

Key words: Rituximab, Platelet transfusion refractoriness, Hematopoietic stem cell transplantation

江和碧, 张晓红, 江华. 利妥昔单抗治疗造血干细胞移植后血小板输注无效的临床疗效[J]. 广州医药, 2018, 49(6): 13-16.

JIANG Hebi, ZHANG Xiaohong, JIANG Hua. Efficiency of treatment with rituximab in platelet transfusion refractoriness after hematopoietic stem cell transplantation[J]. Guangzhou Medical Journal, 2018, 49(6): 13-16.

参考文献

[1] LUBAN N L,MCBRIDE E,FORD J C,et a1.Transfusion medicine problems and solutions for the pediatric hematologist/oncologist[J].Pediatr Blood Cancer,2012,58(7):1106-1111.
[2] LI G,LIU F,MAO X,et a1.The investigation of platelet transfusion refractory in 69 malignant patients undergoing hematopoietic stem cell transplantation[J].Transfus Apher Set,2011,45(1):21-24.
[3] RADIA R,PAMPHILON D.Transfusion strategies in patients undergoing stem-cell transplantation[J]. Expert Rev Hematol,2011,4(2):213-220.
[4] 王谦明,张晓辉.造血干细胞移植术后血小板输注无效的诊治[J]. 中华内科杂志,2015,54(3):232-234.
[5] SOLVES P,SANZ J,FREIRIA C,et al.Factors influencing platelet transfusion refractoriness in patients undergoing allogeneic hematopoietic stem cell transplantation[J]. Ann Hematol,2018,97(1):161-167.
[6] CID J,MAGNANO L,ACOSTA M,et al.Rituximab,plasma exchange and intravenous immunoglobulins as a new treatment strategy for severe HLA alloimmune platelet refractoriness[J]. Platelets,2015,26(2):190-194.
[7] WANG J,XIA W,DENG J,et al,Analysis of platelet-reactive alloantibodies and evaluation of cross-match-compatible platelets for the management of patients with transfusion refractoriness[J]. Transfus Med,2018,28(1):40-46.
[8] PAI S C,LO S C,LIN T S,et al.Epitope-based matching for HLA-alloimmunized platelet refractoriness in patients with hematologic diseases[J]. Transfusion,2010,50(11):2318-2327.
[9] SAILLER L.Rituximab off label use for difficult-to-treat auto-immune diseases: reappraisal of benefits and risks[J]. Clin Rev Allergy Immunol,2008,34(1):103-110.
[10] LIU W,WU D,HU T,et al.Efficiency of treatment with rituximab in platelet transfusion refractoriness: a study of 7 cases[J]. Int J Clin Exp Med,2015,8(8):14080-14084.
[11] GUO L,KAPUR R,ASLAM R,et al.CD20+ B-cell depletion therapy suppresses murine CD8+ T-cell-mediated immune thrombocytopenia[J]. Blood,2016,127(6):735-738.
[12] ROBERTS D M,JONES R B,SMITH R M,et al.Rituximab-associated hypogammaglobulinemia: incidence,predictors and outcomes in patients with multi-system autoimmune disease[J]. J Autoimmun,2015(57):60-65.

利妥昔单抗治疗造血干细胞移植后血小板输注无效的临床疗效

Efficiency of treatment with rituximab in platelet transfusion refractoriness after hematopoietic stem cell transplantation

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