Ratanatharathorn V, Carson E, Reynolds C, Ayash L J, Levine J, Yanik G, Silver S M, Ferrara J L, Uberti J P
Blood and Marrow Stem Cell Transplant Program, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109, USA.
Ann Intern Med. 2000 Aug 15;133(4):275-9. doi: 10.7326/0003-4819-133-4-200008150-00011.
Autoimmune thrombocytopenia in chronic graft-versus-host disease may represent an instance of B-cell dysregulation leading to clinical disease.
To attempt to treat refractory immune-mediated thrombocytopenia in a patient with chronic graft-versus-host disease by using anti-CD20 chimeric monoclonal antibody.
Case report.
Academic medical center.
A patient with chronic graft-versus-host disease after allogeneic peripheral blood stem-cell transplantation who had severe refractory immune-mediated thrombocytopenia.
Weekly infusion of rituximab, 375 mg/m2, for 4 weeks.
Platelet count, CD3+ cell count, and CD19+ cell count.
Rituximab therapy resulted in marked depletion of B cells in the peripheral blood and decreased levels of platelet-associated antibody. The increase in platelet count persisted despite tapering and discontinuation of immunosuppressive therapy for chronic graft-versus-host disease.
The efficacy of rituximab for the treatment of immune-mediated thrombocytopenia suggests that this drug may have activity in other autoimmune diseases or chronic graft-versus-host disease.
慢性移植物抗宿主病中的自身免疫性血小板减少可能是B细胞调节异常导致临床疾病的一个实例。
尝试使用抗CD20嵌合单克隆抗体治疗一名慢性移植物抗宿主病患者的难治性免疫介导性血小板减少。
病例报告。
学术医疗中心。
一名异基因外周血干细胞移植后发生慢性移植物抗宿主病且患有严重难治性免疫介导性血小板减少的患者。
每周输注利妥昔单抗，剂量为375mg/m²，共4周。
血小板计数、CD3⁺细胞计数和CD19⁺细胞计数。
利妥昔单抗治疗导致外周血B细胞显著减少，血小板相关抗体水平降低。尽管逐渐减少并停用了慢性移植物抗宿主病的免疫抑制治疗，但血小板计数仍持续升高。
利妥昔单抗治疗免疫介导性血小板减少的疗效表明，该药可能对其他自身免疫性疾病或慢性移植物抗宿主病有效。
Zotero 插件