Gottardo Nick G, Baker David L, Willis Frank R
Department of Pediatric Oncology and Hematology, Princess Margaret Hospital for Children, Perth, Western Australia.
Pediatr Hematol Oncol. 2003 Oct-Nov;20(7):557-61. doi: 10.1080/08880010390232781.
Childhood autoimmune hemolytic anemia (AIHA) of the warm type is usually successfully managed with corticosteroids and/or immunoglobulin infusions. In a small proportion of patients AIHA follows a more severe and protracted pathway resulting in the use of immunosuppressive therapy and frequently culminating with the need for splenectomy. Rituximab is an anti-CD20 (B-cell) monoclonal antibody used for the treatment of patients with relapsed or refractory low-grade or follicular, CD20 positive, B-cell non-Hodgkin's lymphoma. Case reports on the use of rituximab for childhood AIHA are scant. The authors describe the first report in which rituximab was effectively employed to induce a long-term remission in a young child with the longest history of chronic relapsing AIHA prior to receiving rituximab. All immunosuppressive therapy was successfully discontinued and splenectomy was avoided.
儿童温抗体型自身免疫性溶血性贫血（AIHA）通常通过使用皮质类固醇和/或输注免疫球蛋白得到成功治疗。在一小部分患者中，AIHA会遵循更严重且病程更长的路径，导致需要使用免疫抑制疗法，并且常常最终需要进行脾切除术。利妥昔单抗是一种抗CD20（B细胞）单克隆抗体，用于治疗复发或难治性低度或滤泡性、CD20阳性、B细胞非霍奇金淋巴瘤患者。关于利妥昔单抗用于儿童AIHA的病例报告很少。作者描述了首例报告，其中利妥昔单抗有效地诱导了一名患有慢性复发性AIHA病史最长的幼儿长期缓解，在接受利妥昔单抗治疗之前，所有免疫抑制疗法均成功停用，且避免了脾切除术。
