低剂量利妥昔单抗治疗温抗体型自身免疫性溶血性贫血的系统评价  

A systematic review of low-dose rituximab monodonal antibody in the treatment of warm autoimmune hemolytic anemia

作　　者：陈苗[1] 庄俊玲[1] CHEN Miao ZHUANG Jun-ling(Dept. of Hematology, Peking Union Medical College Hospital, CAMS ＆ PUMC ,Beijing 100730, China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院血液内科,北京100730

出　　处：《基础医学与临床》2017年第10期1444-1448,共5页Basic and Clinical Medicine

摘　　要：目的标准剂量利妥昔单抗(RTX)(375 mg/m2/周×4)已成为难治复发温抗体型自身免疫性溶血性贫血(w AIHA)的首选二线治疗。尽管如此,低剂量RTX治疗w AIHA的疗效仍值得探讨。方法通过对PUBMED数据库和CNKI数据库的文献检索,本研究共纳入13项临床研究,对172例患者进行系统评价。结果低剂量RTX(100 mg/周×4)治疗w AIHA总反应率达到87.8%,其中完全缓解(CR)率62.8%,部分缓解(PR)率25%。由于病例数少,各组报道复发率差异较大,从0~62.5%不等,复发后再治疗仍有有效病例报道。无严重不良反应。结论低剂量RTX治疗w AIHA安全有效,不良反应少。Objective Standard dose of rituximab monodonal antibody（ Mc Ab）（ 375 mg/m2/week × 4） has been recommended as a salvage regimen for refractory and recurrent warm autoimmune hemolytic anemia（ w AIHA）. The effect of low-dose rituximab in w AIHA needs more evaluation. Methods Through a comprehensive literature search through P UBMED and CNKI databases,13 articles of 172 cases were reviewed. Results The current understanding of low-dose rituximab in w AIHA is limited. Based on the summary of these studies,the overall response rate was 87. 8 % with 62. 8 % complete response and 25 % partial response. Since each study only enrolled several cases,the relapse rates markedly varied from 0 to 62. 5 %. Nevertheless,retreatment of low-dose rituximab was still effective in some relapsed patients. No significant adverse event was reported. Conclusions P resent literature analysis suggests that low-dose rituximab could be an effective and safe therapy for w AIHA.

关 键 词：温抗体型自身免疫性溶血性贫血 利妥昔单抗 抗CD20单克隆抗体 低剂量 

分 类 号：R556.62[医药卫生—血液循环系统疾病]