Department of Internal Medicine, Division of Hematology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye.
Department of Internal Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye.
J Oncol Pharm Pract. 2023 Jun;29(4):1011-1014. doi: 10.1177/10781552221142870. Epub 2022 Dec 1.
Rituximab, which is widely used in the treatment of B-cell lymphoma, is a chimeric monoclonal antibody directed against the CD20 antigen. Rituximab has many side effects, mainly allergic and neurological. Rituximab may cause thrombocytopenia in the long term after administration. Rare cases of rituximab-induced acute thrombocytopenia have been reported in the literature.
A 51-year-old female patient who was newly diagnosed with splenic marginal zone lymphoma received rituximab as first-line therapy. Petechiae occurred in the lower extremities on the day following rituximab administration. The blood test showed a severe drop in the platelet count from 112,000/μL to 5000/μL. Blood peripheral smear evaluation confirmed severe thrombocytopenia.
There was no change in hemoglobin or white blood cell levels. After the diagnosis of rituximab-induced acute thrombocytopenia, thrombocyte suspension was administered due to the risk of bleeding. Close clinical and laboratory observations were made. The platelet count began to rise gradually in the following period. Before the second week of rituximab administration, the platelet count was 122,000/μL. No complications developed after premedication and slow rituximab administration, and subsequent treatments were continued in the same way.
Rituximab has widespread use, especially in malignancies and autoimmune diseases. Like many monoclonal antibodies, rituximab has several side effects. Thrombocytopenia is a long-term side effect associated with rituximab, and rituximab-induced severe acute thrombocytopenia has been rarely reported. Therefore, it should be kept in mind that severe acute thrombocytopenia may develop after rituximab administration.
利妥昔单抗广泛用于治疗 B 细胞淋巴瘤，是一种针对 CD20 抗原的嵌合单克隆抗体。利妥昔单抗有许多副作用，主要是过敏和神经方面的。利妥昔单抗在给药后长期可能会导致血小板减少症。文献中报道了罕见的利妥昔单抗诱导的急性血小板减少症病例。
一位 51 岁女性新诊断为脾边缘区淋巴瘤患者，接受利妥昔单抗作为一线治疗。利妥昔单抗给药后第二天下肢出现瘀点。血液检查显示血小板计数从 112000/μL 严重下降至 5000/μL。外周血涂片评估证实严重血小板减少症。
血红蛋白或白细胞水平没有变化。在诊断为利妥昔单抗诱导的急性血小板减少症后，由于出血风险，给予血小板悬浮液。密切观察临床和实验室情况。血小板计数在接下来的时期开始逐渐上升。在利妥昔单抗给药的第二周前，血小板计数为 122000/μL。在预用药和缓慢给予利妥昔单抗后没有出现并发症，并以同样的方式继续后续治疗。
利妥昔单抗用途广泛，特别是在恶性肿瘤和自身免疫性疾病中。与许多单克隆抗体一样，利妥昔单抗有几种副作用。血小板减少症是与利妥昔单抗相关的长期副作用，并且很少有报道利妥昔单抗诱导的严重急性血小板减少症。因此，应牢记在给药后可能会发生严重的急性血小板减少症。
