重组人血小板生成素联合小剂量利妥昔单抗治疗激素无效/复发成人ITP的多中心临床研究  

Combination therapy with recombinant human thrombopoietin and low-dose rituximab for corticosteroid-resistant/relapsed adult ITP:a multicenter clinical trial

作　　者：刘新光[1] 刘晓帆 孟月生[3] 曾庆曙[4] 周郁鸿[5] 张梅[6] 王晓敏[7] 王欣[8] 郭农建[9] 方美云[10] 周芳[11] 徐瑞荣[12] 袁成录 冯莹[14] 杨仁池 秦平[1] 彭军[1] 侯明[1] 

机构地区：[1]山东大学齐鲁医院血液科,济南250012 [2]中国医学科学院血液学研究所血液病医院 [3]青岛市立医院 [4]安徽医科大学第一附属医院 [5]浙江省中医院 [6]西安交通大学第一附属医院 [7]新疆自治区人民医院 [8]山东省立医院 [9]济南市中心医院 [10]大连医科大学附属第一医院 [11]济南军区总医院 [12]山东省中医院 [13]青岛市中心医院 [14]广州医学院第二附属医院

出　　处：《临床血液学杂志》2015年第5期778-781,共4页Journal of Clinical Hematology

摘　　要：目的：探讨重组人血小板生成素（rhTPO）联合小剂量利妥昔单抗（LD-RIT）对激素无效／复发的成人原发免疫性血小板减少症（ITP）的疗效和安全性。方法：激素治疗无效／复发的ITP患者91例，应用rhTPO联合LD-RIT治疗。结果：治疗至第14天时患者完全有效率为40．7％，总有效率为71．4％；第28天治疗终止时，患者完全有效率为42．9％，总有效率为75．8％；ITP患者中位起效时间为9（4～35）d；治疗结束后随访至50天及90天时，患者复发率分别为27．1％、35．7％；治疗第14、28、90天时，患者出血评分均较治疗前明显降低（P〈0．001）；所有患者对rhTPO、LD-RIT治疗耐受良好。结论：rhTPO联合LD-RIT治疗激素无效／复发的ITP患者，可快速提升血小板水平，显著缩短起效时间，减少出血风险，是一项有潜力的ITP二线治疗方案。Objective： To evaluate the efficacy and safety of combination therapy with recombinant human thrombopoietin （rhTPO） and low-dose rituximab （LD-RIT） for corticosteroid-resistant/relapsed adult ITP. Meth- od：A total of 91 corticosteroid-resistant/relapsed ITP patients were treated with combination therapy of rhTPO and LD-RIT. Result：The complete response rate （CRR） and overall response rate （ORR） at the end of the second week after the initial treatment were 40.7% and 71.4o//00 respectively. At the end of fourth week,CRR was 42.9%, and ORR was 75.8%. The median time to response was 9 （4 to 35） days. Relapse rate during follow-up at the 50th day and the 90th day was 27.1% and 35.7 % respectively. Bleeding scores at the 14th, 28th, 90th day were signifi- cantly lower than that before treatment （P〈0. 001）. All patients were well tolerated to rhTPO and LD-RIT thera- py. Conclusion：Combination therapy with rhTPO and LD-RIT is effective to corticosteroid-resistant/relapsed ITP patients, with a relatively short time to response and low bleeding risks, and it may be considered as a potential sec- ond-line treatment regimen for ITP.

关 键 词：重组人血小板生成素 利妥昔单抗 原发免疫性血小板减少症 

分 类 号：R558.2[医药卫生—血液循环系统疾病]