Lundin Jeanette, Karlsson Claes, Celsing Fredrik
Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.
Med Oncol. 2006;23(1):137-9. doi: 10.1385/MO:23:3.
B-cell chronic lymphocytic leukemia (B-CLL) is the most common cause of autoimmune hemolytic anemia (AIHA), and a subgroup of these patients who develop both these conditions fail to respond to corticosteroids, cytotoxic drugs, splenectomy, and iv immunoglobulins. Alemtuzumab is a humanized anti-CD52 monoclonal antibody that is an effective therapy for B-CLL, mycosis fungoides, and T-cell prolymphocytic leukemia. Here we present a case report of a 78-yr-old woman with B-CLL and progressive life-threatening AIHA with hemoglobin count 5.5 g/dL following fludarabine treatment, who was treated successfully with alemtuzumab. The anemia was completely reversed and hemoglobin count remains at 14 g/dL after 15 mo of unmaintained follow-up. No infectious complications were noted during or after alemtuzumab therapy. We conclude that alemtuzumab may be indicated for the treatment of AIHA in B-CLL patients who have failed other treatments.
B 细胞慢性淋巴细胞白血病（B-CLL）是自身免疫性溶血性贫血（AIHA）最常见的病因，而同时患有这两种疾病的患者亚组对皮质类固醇、细胞毒性药物、脾切除术和静脉注射免疫球蛋白均无反应。阿仑单抗是一种人源化抗 CD52 单克隆抗体，对 B-CLL、蕈样肉芽肿和 T 细胞幼淋巴细胞白血病是一种有效的治疗方法。在此，我们报告一例 78 岁患有 B-CLL 和进行性危及生命的 AIHA 的女性病例，该患者在接受氟达拉滨治疗后血红蛋白计数为 5.5 g/dL，经阿仑单抗成功治疗。贫血完全逆转，在 15 个月的非维持性随访后血红蛋白计数仍保持在 14 g/dL。在阿仑单抗治疗期间及之后均未发现感染并发症。我们得出结论，对于其他治疗无效的 B-CLL 患者，阿仑单抗可能适用于 AIHA 的治疗。
