利妥昔单抗治疗长脊髓损害的初步分析

B-Lymphocyte depletion with rituximab in patients with longitudinally extensive spinal cord lesion

目的探讨利妥昔单抗治疗长脊髓损害(LESCL)的临床疗效及安全性。方法收集2010年首都医科大学宣武医院神经内科经糖皮质激素治疗无效的LESCL住院患者2例,治疗前2例患者扩展残疾状态量表(expanded disability status scale,EDSS)评分均为8.5分。对两患者均予利妥昔单抗500mg治疗1次,并随访6个月。分别于治疗后1周检测患者的淋巴细胞亚群CD19+CD20+细胞比例,评价治疗后6个月时的EDSS评分,并观察治疗期间(治疗之后至6个月)有无发热、寒战、低血压等不良反应。结果应用利妥昔单抗治疗1周后,两患者淋巴细胞亚群CD19+CD20+细胞比例均为0.00%。6个月后随访,病例1和病例2的EDSS评分分别为6.5分和2.5分,两患者均无明显不良反应。结论利妥昔单抗可能是一种治疗LESCL的有效药物。

Objective To describe the effect and tolerance of rituximab treatment in patients with longitudinally extensive spinal cord lesions. Methods Two patients with longitudinally extensive spinal cord lesions were admitted in Xuanwu hospital in whom the hormone pulse therapy was inefficacy.Expanded disability status scale（EDSS） was 8.5 in the 2 patients before treatment.Both patients were treated by 500 mg rituximab and were followed up for 6 months.The ratio of CD19＋CD20＋ cells was detected after 1 week＇s treatment.The adverse events were observed,such as fever,chill and hypotension,during the period of 0 to 6 months after treatment. Results CD19＋CD20＋ cells ratio were 0.00% in these 2 cases after 1 week＇s infusion of rituximab.The patients were followied up for 6 months,EDSS was 6.5 in case 1,and 2.5 in case 2.There were not obvious side effects. Conclusions Rituximab could be an effective and safe therapy for longitudinally extensive spinal cord lesion.