利妥昔单抗治疗难治性广泛cGVHD的疗效观察  

Therapeutic effect of Rituximab on refractory extensive chronic graft-versus-host disease

作　　者：李杰平[1] 曾东风[1] 陈幸华[1] 张曦[1] 刘红[1] 王庆余[1] 向茜茜[1] 孔佩艳[1] 

机构地区：[1]第三军医大学新桥医院血液科/重庆市医学重点学科,重庆400037

出　　处：《国际检验医学杂志》2011年第11期1165-1167,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨利妥昔单抗治疗难治性广泛性慢性移植物抗宿主病治疗中的疗效及作用机制。方法对2例难治性广泛性慢性移植物抗宿主病患者,在原有治疗基础上联合利妥昔单抗治疗后部分缓解患者的临床资料进行分析,并结合文献复习,为难治性广泛性慢性移植物抗宿主病的治疗提供新的思路。2例患者均表现广泛或局限的硬皮病、干眼症、肝功能损害、口腔广泛性溃疡损害和(或)增殖性病变等广泛性慢性移植物抗宿主病,利妥昔单抗治疗方案:静脉注射利妥昔单抗375 mg/m2,每周1次,连用4周后改为每个月1次,共用6次。结果 2例患者均获得明显改善并明显减少激素用量,患者慢性移植物抗宿主病持续好转并无病存活。利妥昔单抗治疗期间未发生任何严重不良反应。结论利妥昔单抗治疗难治性广泛性cGVHD安全有效,对于激素和环孢素耐药的cGVHD具有良好效果。提示B细胞在cGVHD发病机制中具有重要的作用。Objective To evaluate the therapeutic effect and mechanism of Rituximab in the treatment of refractory extensive chronic graft-versus-host disease（cGVHD）. Methods The clinical data of 2 cases of patients with refractory extensive cGVHD, getting partial remission after the combined therapy of routine method and Rituxmab therapy, were analyzed to provide new protocol for the treatment of refractory extensive cGVHD. Both patients were with extensive cGVHD,sueh as diffusing or localized seleroderma, xerophthalmia, liver damage, extensive ulcer of oral cavity, proliferation diseases, and so on, were treated with Rituximab（375 mg/m2） once per-week for 4 consecutive weeks and then once per-month for 2 consecutive months. Results Both of the 2 cases showed partial response,while the application dose of steroids was reduce,with the improvement of pathogenetic condition,and acquire survival without complications. Conclusion Rituximab therapy might be safe and effective for the treatment of refractory extensive eGVHD,espeeially for the treatment of steroid and eiclosporin resistant cGVHD. Findings in this research suggest that B lymphocytes take an important role in the pathogenesis of cGVHD.

关 键 词：移植物抗宿主病 造血干细胞移植 利妥昔单抗 

分 类 号：R457[医药卫生—治疗学]