小剂量利妥昔单抗治疗老年自身免疫性溶血性贫血的临床研究  

Lower dose of rituximab in the treatment of elderly autoimmune hemolytic anemia

作　　者：张小坤[1] 孙杰[2] 

机构地区：[1]河北医科大学附属邢台市人民医院血液科,邢台054000 [2]河北医科大学重症医学科,邢台054000

出　　处：《中华血液学杂志》2014年第3期236-238,共3页Chinese Journal of Hematology

摘　　要：目的探讨小剂量利妥昔单抗治疗老年溶血性贫血的疗效及安全性。方法以37例初诊老年自身免疫性溶血性贫血（AIHA）患者为研究对象，对25例患者应用泼尼松1mg·kg^-1·d^-1，4周后评估疗效。对12例因合并各种疾病不能使用泼尼松治疗患者应用利妥昔单抗，每次100mg，每周1次，连用4次后评估疗效。结果25例泼尼松治疗患者中，完全缓解5例，部分缓解15例，无效5例，完全缓解率20．0％，有效率80．0％。12例给予小剂量利妥昔单抗治疗患者中，完全缓解8例，部分缓解3例，无效1例，完全缓解率66．7％，有效率91．7％。小剂量利妥昔单抗治疗组完全缓解率明显高于泼尼松组，差异有统计学意义（P=0．038）。结论小剂量利妥昔单抗治疗老年AIHA患者安全性、有效性均优于泼尼松。Objectives To explore the safety and efficacy of lower dose of rituximab in the treatment of elderly autoimmune hemolytic anemia （AIHA）. Methods From May 2008 to February 2013, a total of 37 patients with newly diagnosed elderly AIHA patients were enrolled in the study, including 25 cases treated with prednisone 1 mg . kg^-1. d^-1 for 4 weeks and 12 cases ineligible for glucocorticoid receiving rituximab （100 mg/week for 4 times）. Results Of the 25 patients with conventional glucocorticoid, 5 cases （20.0%） were complete remission （CR）, 15 cases with partial remission （PR） and 5 cases without response. The overall response rate was 80.0%. Of the 12 cases with rituximab, 8 cases （66.7%） were CR, 3 cases with PR and 1 without response. The overall response rate was 91.7%. A significantly higher CR rate was seen in lower dose of rituximab, as compared to that in conventional glucocorticoid （P=0.038）. Conclusion A lower dose of rituximab, with satisfactory safety and efficacy, was better than the conventional glucocorticoid in the treatment of elderly AIHA patients.

关 键 词：老年人 贫血 溶血性 自身免疫性 利妥昔单抗 

分 类 号：R556.6[医药卫生—血液循环系统疾病]