[利妥昔单抗诱导的慢性淋巴细胞白血病患者急性血小板减少症]
[Rituximab-induced acute thrombocytopenia in a patient with chronic lymphocytic leukemia].
作者信息
Bobot M, Benzaquen M, Rouby F, Lebowitz D, Serratrice J, Durand J-M
机构信息
Service de néphrologie, hôpital La-Conception, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, 147, boulevard Baille, 13005 Marseille, France.
Service de dermatologie, hôpital Nord, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, chemin des Bourrely, 13015 Marseille, France.
出版信息
Rev Med Interne. 2017 May;38(5):344-346. doi: 10.1016/j.revmed.2016.08.008. Epub 2016 Sep 14.
INTRODUCTION
Rituximab is a chimeric anti-CD20 monoclonal antibody generally well tolerated. However, a severe but rare rituximab-related immune-toxic syndrome, associating fever, chills and thrombocytopenia can occur shortly after the infusion.
CASE REPORT
We report a case of severe acute rituximab-induced thrombocytopenia with favorable outcome in a patient with chronic lymphocytic leukemia and discuss the possible underlying mechanisms.
CONCLUSION
Despite the potential initial severity of rituximab-induced thrombocytopenia in CLL, chemotherapy should not be discontinued; tolerance might increase as the hematologic disorder is controlled.
引言
利妥昔单抗是一种嵌合抗CD20单克隆抗体，通常耐受性良好。然而，在输注后不久可能会出现一种严重但罕见的与利妥昔单抗相关的免疫毒性综合征，伴有发热、寒战和血小板减少。
病例报告
我们报告了一例慢性淋巴细胞白血病患者发生严重急性利妥昔单抗诱导的血小板减少且预后良好的病例，并讨论了可能的潜在机制。
结论
尽管在慢性淋巴细胞白血病中利妥昔单抗诱导的血小板减少最初可能很严重，但不应停止化疗；随着血液系统疾病得到控制，耐受性可能会增加。
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