Aitken Lucy, Patel Ronak, D'Rozario James, Choi Philip
Canberra Hospital, Canberra, 2605, ACT, Australia.
Calvary Hospital, Canberra, 2617, ACT, Australia.
Immunotherapy. 2022 Feb;14(2):95-99. doi: 10.2217/imt-2021-0163. Epub 2021 Nov 8.
We report on the presentation and outcome of a 28-year-old female who developed red cell aplasia following alemtuzumab therapy for relapsing remitting multiple sclerosis. The patient also developed synchronous immune thrombocytopenia and immune neutropenia, but not aplastic anemia. This patient received high dose steroids, intravenous immunoglobulin (iv.Ig), rituximab, red cell transfusions, vincristine, G-CSF, cyclosporin and mycophenolate to treat the combination of cytopenias over a period of 6 months with subsequent improvement in bone marrow function. While alemtuzumab has several recognized autoimmune complications, little is known about the potential hematological side effects. The combination of red cell aplasia, immune thrombocytic purpura and autoimmune neutropenia has not previously been described in the literature following alemtuzumab immunotherapy and highlights the importance of monthly blood monitoring post alemtuzumab administration.
我们报告了一名28岁女性的病例，该患者在接受阿仑单抗治疗复发缓解型多发性硬化症后出现了红细胞再生障碍。该患者还同时出现了免疫性血小板减少和免疫性中性粒细胞减少，但未出现再生障碍性贫血。该患者接受了大剂量类固醇、静脉注射免疫球蛋白（iv.Ig）、利妥昔单抗、红细胞输注、长春新碱、粒细胞集落刺激因子（G-CSF）、环孢素和霉酚酸酯治疗血细胞减少症的组合，为期6个月，随后骨髓功能有所改善。虽然阿仑单抗有几种公认的自身免疫并发症，但对其潜在的血液学副作用知之甚少。阿仑单抗免疫治疗后，红细胞再生障碍、免疫性血小板紫癜和自身免疫性中性粒细胞减少的组合此前在文献中尚未有描述，这凸显了阿仑单抗给药后每月进行血液监测的重要性。
