Zaja Francesco, Vianelli Nicola, Sperotto Alessandra, Patriarca Francesca, Tani Monica, Marin Luciana, Tiribelli Mario, Candoni Anna, Baccarani Michele, Fanin Renato
Clinica Ematologica, Policlinico Universitario, P. zza S. M. Misericordia, 33100 Udine, Italy.
Leuk Lymphoma. 2003 Nov;44(11):1951-5. doi: 10.1080/1042819031000119235.
Rituximab is active in chronic lymphocytic leukemia (CLL) and may interfere with autoantibodies production in some immune diseases. We report the results of rituximab treatment in 7 patients with CLL-associated symptomatic autoimmune diseases refractory to standard immunosuppressive therapies: warm antibody hemolytic anemia (AHA) 4 patients, cold agglutinin disease (CAD) 1, immune thrombocytopenia (IT) 1, axonal degenerating neuropathy (ADN) 1. Rituximab was given at the dose of 375 mg/m2 per week for 4 weeks. One patient with AHA and one with CAD achieved complete normalization of hemoglobin levels and laboratory signs of haemolysis, with response duration (RD) of 8+ and 38+ months, respectively. In the patient with IT, complete remission was reached after the first week of treatment and RD was 6 months. The patient with ADN achieved a marked neurological improvement after rituximab therapy, with RD of 12 months. Retreatment of both patients with IT and ADN was effective. Rituximab may be an alternative agent for the treatment CLL-associated autoimmune diseases.
利妥昔单抗对慢性淋巴细胞白血病（CLL）有效，且可能在某些免疫疾病中干扰自身抗体的产生。我们报告了利妥昔单抗治疗7例对标准免疫抑制疗法难治的CLL相关症状性自身免疫疾病患者的结果：温抗体型溶血性贫血（AHA）4例、冷凝集素病（CAD）1例、免疫性血小板减少症（IT）1例、轴索性变性神经病（ADN）1例。利妥昔单抗以375mg/m²的剂量每周给药1次，共4周。1例AHA患者和1例CAD患者的血红蛋白水平及溶血实验室指标完全恢复正常，缓解持续时间（RD）分别为8个月以上和38个月以上。IT患者在治疗第1周后达到完全缓解，RD为6个月。ADN患者在利妥昔单抗治疗后神经功能有显著改善，RD为12个月。IT和ADN患者再次治疗均有效。利妥昔单抗可能是治疗CLL相关自身免疫疾病的一种替代药物。
