Kunitomi Akane, Konaka Yoshiteru, Yagita Masato, Nishimoto Norihiro, Kishimoto Tadamitsu, Takatsuki Kiyoshi
Department of Medicine, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka, Japan.
Int J Hematol. 2004 Oct;80(3):246-9. doi: 10.1532/ijh97.04058.
Refractory autoimmune hemolytic anemia (AIHA) is associated with considerable rates of mortality. Interleukin 6 (IL-6) has been reported to play a role in the pathogenesis of AIHA. This report describes a patient with AIHA who was successfully treated with a humanized anti-human IL-6 receptor (IL-6R) monoclonal antibody (MoAb). He had experienced life-threatening AIHA and had received conventional therapy with corticosteroids, azathioprine, cyclophosphamide, cyclosporin A, melphalan, plasma exchange, and irradiation to his spleen. However, the patient's symptoms and laboratory data did not show a sufficient improvement. Because his serum IL-6 level was elevated, we attempted to block IL-6 signaling by using a humanized anti-IL-6R MoAb, MRA. With 8 mg/kg of MRA administration every 2 weeks, the serum hemoglobin level gradually increased and normalized within 4 months. After 2 years of MRA treatment, the disease activity was well controlled without adverse reactions. Anti-IL-6R MoAb can be a novel and effective therapeutic agent for AIHA.
难治性自身免疫性溶血性贫血（AIHA）的死亡率相当高。据报道，白细胞介素6（IL-6）在AIHA的发病机制中起作用。本报告描述了一名AIHA患者，他接受人源化抗人IL-6受体（IL-6R）单克隆抗体（MoAb）治疗后获得成功。他曾经历危及生命的AIHA，并接受了皮质类固醇、硫唑嘌呤、环磷酰胺、环孢素A、美法仑、血浆置换和脾脏照射等常规治疗。然而，患者的症状和实验室数据并未显示出足够的改善。由于他的血清IL-6水平升高，我们尝试使用人源化抗IL-6R MoAb（MRA）阻断IL-6信号传导。每2周给予8 mg/kg的MRA，血清血红蛋白水平逐渐升高，并在4个月内恢复正常。经过2年的MRA治疗，疾病活动得到良好控制，且无不良反应。抗IL-6R MoAb可能是一种用于AIHA的新型有效治疗药物。
