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[利妥昔单抗给药后严重迟发性中性粒细胞减少症]

[Severe late-onset neutropenia after rituximab administration].

作者信息

Schütte Carla E, Hillebrecht Christina, Kuipers Jens G, Stichtenoth Dirk O, Strunz Patrick-Pascal, Heck Johannes

机构信息

Institut für Klinische Pharmakologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.

Klinik für internistische Rheumatologie, Rotes Kreuz Krankenhaus, St.-Pauli-Deich 24, 28199, Bremen, Deutschland.

出版信息

Z Rheumatol. 2025 Jun 4. doi: 10.1007/s00393-025-01668-2.

Abstract

Rituximab (RTX) causes B‑cell depletion by binding to the CD20 antigen. A less well-known adverse drug reaction of RTX is late-onset neutropenia (LON), which occurs approximately 6 months after treatment initiation. As clinical management, regular differential blood cell counts should be performed during RTX treatment. Besides a watch-and-wait strategy, supportive administration of granulocyte colony-stimulating factor (G-CSF) can be discussed for acute LON episodes. Re-exposure to RTX after LON has occurred is generally considered acceptable after diligent benefit-risk evaluation and thorough patient information. In this case series, we would like to present 2 cases of rheumatology patients with severe LON after RTX administration.

摘要

利妥昔单抗(RTX)通过与CD20抗原结合导致B细胞耗竭。RTX一种不太为人所知的药物不良反应是迟发性中性粒细胞减少症(LON),它发生在治疗开始后约6个月。作为临床管理措施,在RTX治疗期间应定期进行血细胞分类计数。除了观察等待策略外,对于急性LON发作,可讨论给予粒细胞集落刺激因子(G-CSF)进行支持治疗。在进行了认真的获益-风险评估并向患者充分告知信息后,LON发生后再次使用RTX通常被认为是可以接受的。在本病例系列中,我们想介绍2例接受RTX治疗后出现严重LON的风湿病患者。

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