小剂量利妥昔单抗为基础治疗32例免疫性血小板减少症疗效评价

Efficacy of low-dose rituximab in treatment of immune thrombocytopenia: An analysis of 32 cases

目的评估小剂量利妥昔单抗在免疫性血小板减少症(immune thrombocytopenia,ITP)治疗中的价值。方法回顾性分析我院2009年1月-2012年12月应用小剂量利妥昔单抗(100 mg/周,连用4周)为基础治疗的32例免疫性血小板减少症患者的疗效。结果 32例ITP患者中可评估29例,完全反应18例,有效5例,无效6例,总反应率79.3%。新诊断ITP患者6例,完全反应1例,有效2例,无效3例;持续性ITP患者5例,完全反应4例,有效1例;慢性ITP患者18例,完全反应13例,有效2例,无效3例。先前治疗史:糖皮质激素有效17例,完全反应12例,有效2例,无效3例;糖皮质激素无效10例,完全反应6例,部分反应3例,无效1例。结论小剂量利妥昔单抗在免疫性血小板减少症治疗中有较好的疗效,不良反应小,可作为有效的二线治疗手段。

Objective To assess the value of low-dose rituximab in treatment of immune thrombocytopenia. Methods Clinical data about 32 patients with immune thrombocytopenia who were treated with low-dose rituximab in our hospital from January 2009 to December 2012 were retrospectively analyzed. Results Of the 32 cases, 29 cases Could be assessed, including complete response in 18 cases, response in 5 cases, no response in 6 cases, with the total response rate of 79.3%. Newly diagnosed ITP were found in 6 cases, including complete response in 1 case, response in 2 cases, no response in 3 cases. Persistent ITP were found in 5 cases, including complete response in 4 cases, response in 1 case. Chronic ITP were found in 18 cases, including complete response in 13 cases, response in 2 cases, no response in 3 cases. According to the previous response, glucocorticoid were found to be active in 17 cases, including complete response in 2 cases, response in 2 cases, no response 3 in cases. While glucocorticoid were found to be inactive in 10 cases, including complete response in 6 cases, response in 3 cases, no response in 1 case. Conclusion Low-dose rituximab shows good effect in treatment of immune thrombocytopenia without any strong adverse, so it can be an effective second- line therapy for patients with ITP.