Robak Tadeusz
Department of Hematology, Medical University of Lodz and Copernicus Hospital, Lodz, Poland.
Eur J Haematol. 2004 Feb;72(2):79-88. doi: 10.1046/j.0902-4441.2003.00196.x.
In recent years, clinical studies have been undertaken with selected monoclonal antibodies (MoAbs) in the treatment of several hematological diseases, especially in malignant disorders. However, some clinical observations indicate that MoAbs may be an important alternative for the conventional therapy of some autoimmune disorders. Two MoAbs directed against CD20 antigen (rituximab, Rituxan, Mabthera) and CD52 antigen (alemtuzumab, Campath-1H) seem to be especially useful for this purpose. Autoimmune cytopenias have been investigated in the last few years with positive preliminary results. Rituximab seems to be an effective and safe agent for the treatment of immune thrombocytopenias, autoimmune hemolytic anemia, cold agglutinin disease and pure red cell aplasia. Although the case series are small, rituximab seems to be an effective and safe agent for the treatment of these diseases. Clinical experience with alemtuzumab in patients with autoimmune cytopenias is even more limited than with rituximab. However, preliminary results indicate that further studies with this MoAb are warranted. A longer follow-up and the studies on larger number of patients are needed to determine the real value of these new approaches in autoimmune cytopenias. Recent experiences with the use of MoAbs in treatment of these diseases are the subject of this review.
近年来，已开展了一些关于特定单克隆抗体（MoAbs）治疗多种血液系统疾病的临床研究，尤其是在恶性疾病方面。然而，一些临床观察表明，单克隆抗体可能是某些自身免疫性疾病传统治疗的重要替代方法。两种针对CD20抗原的单克隆抗体（利妥昔单抗，美罗华， Mabthera）和针对CD52抗原的单克隆抗体（阿仑单抗，Campath - 1H）似乎在此方面特别有用。过去几年对自身免疫性血细胞减少症进行了研究，取得了初步阳性结果。利妥昔单抗似乎是治疗免疫性血小板减少症、自身免疫性溶血性贫血、冷凝集素病和纯红细胞再生障碍性贫血的一种有效且安全的药物。尽管病例系列较小，但利妥昔单抗似乎是治疗这些疾病的一种有效且安全的药物。阿仑单抗用于自身免疫性血细胞减少症患者的临床经验比利妥昔单抗更为有限。然而，初步结果表明有必要对这种单克隆抗体进行进一步研究。需要更长时间的随访以及对更多患者的研究来确定这些新方法在自身免疫性血细胞减少症中的实际价值。本文综述了近期使用单克隆抗体治疗这些疾病的经验。
