Franchini Massimo, Veneri Dino, Lippi Giuseppe, Stenner Rachel
Servizio di Immunoematologia e Trasfusione - Centro Emofilia, Ospedaliera di Verona, Verona, Italy.
Thromb Haemost. 2006 Aug;96(2):119-25.
Rituximab is a chimeric anti-CD20 monoclonal antibody active against normal and malignant B cells which has proven to be effective in the therapy of CD-20 positive lymphomas. Its B-cell cytotoxic action has also been exploited in many non-malignant autoimmune disorders in which it has been used with the aim of interfering with the production of pathologic antibodies. The present knowledge regarding the use of rituximab in antibody-associated disorders of hemostasis (i.e. idiopathic thrombocytopenic purpura, thrombotic thrombocytopenic purpura, acquired hemophilia A, congenital hemophilia with inhibitors, acquired inhibitors against coagulation factors) is presented briefly in this review. The results suggest that rituximab can be useful in the treatment of disorders of hemostasis associated with inhibitor formation. Although collectively the number of patients treated is now quite substantial, most of the data are drawn from isolated case reports or descriptions of small, uncontrolled series. Large, prospective, randomized trials are, therefore, needed to confirm the positive, preliminary results.
利妥昔单抗是一种嵌合型抗CD20单克隆抗体，对正常和恶性B细胞均有活性，已被证明在治疗CD20阳性淋巴瘤方面有效。其B细胞细胞毒性作用也已在许多非恶性自身免疫性疾病中得到应用，目的是干扰病理性抗体的产生。本综述简要介绍了目前关于利妥昔单抗在抗体相关止血障碍（即特发性血小板减少性紫癜、血栓性血小板减少性紫癜、获得性血友病A、伴有抑制剂的先天性血友病、获得性凝血因子抑制剂）中的应用知识。结果表明，利妥昔单抗可用于治疗与抑制剂形成相关的止血障碍。尽管目前接受治疗的患者总数相当可观，但大多数数据来自孤立的病例报告或小型非对照系列的描述。因此，需要进行大型、前瞻性、随机试验来证实这些初步的阳性结果。
