利妥昔单抗治疗免疫性血小板输注无效1例并文献复习

Efficiency of treatment with rituximab in immune platelet transfusion refractoriness:a case report and literature review

目的:探讨利妥昔单抗治疗免疫性血小板输注无效的疗效和安全性。方法:通过观察1例免疫性血小板输注无效患者的临床表现,实验室检查结果,接受利妥昔单抗(375mg/m2)、每周1次、共4次的治疗及转归特点,结合文献进行分析讨论。结果:该患者经利妥昔单抗治疗后抗HLA-A/B抗体变为弱阳性,输注后24h校正血小板计数增加值>4.5×109/L,有效维持时间>6个月,顺利接受异基因造血干细胞移植治疗,疾病恢复。结论:利妥昔单抗可有效治疗免疫性血小板输注无效,且未增加异基因造血干细胞移植的毒副作用,可作为治疗免疫性血小板输注无效的有效手段。

Objective：To evaluate the efficiency and safety of treatment with rituximab in platelet transfusion refractoriness. Method： We analyzed the clinical onset characteristics, high risk factors, diagnosis, curative effect and prognosis of 4 weekly rituximab （375 mg/m2） treatment in a case,to have a further recognition of immune platelet transfusion refractoriness. Result： After treatment with rituximab, the patient＇s anti-HLA-A/B antibodies became weak positive and had good response to platelets transfusion （24 h the corrected count increment 〉4.5 × 10^9/L） last more than 6 months. The patient subsequently received allo-HSCT therapy and recovered fully. Conclusion： Rituximab is a promising treatment for patients with immune platelet transfusion refractoriness and does not increase the side effects of allo-HCST,which can be regarded as an effective mean for treatment of immune platelet transfusion refractoriness.