奥妥珠单抗、糖皮质激素为基础的联合方案治疗复发性免疫性血栓性血小板减少性紫癜4例  

The combined regimen based on obinutuzumab plus glucocorticoid for 4 cases of relapsed iTTP

作　　者：何海菊 李云 田竑[1] 徐晓燕 苏健[1] 葛鑫鑫 吴德沛[1] 余自强[1] 殷杰[1] He Haiju;Li Yun;Tian Hong;Xu Xiaoyan;Su Jian;Ge Xinxin;Wu Depei;Yu Ziqiang;Yin Jie(Jiangsu Institute of Hematology,National Clinical Research Center for Hematologic Diseases,NHC Key Laboratory of Thrombosis and Hemostasis,The First Affiliated Hospital of Soochow University,Collaborative Innovation Center of Hematology,Soochow Universtiy,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院血液内科,江苏省血液研究所,国家血液系统疾病临床医学研究中心,国家卫生健康委员会血栓与止血重点实验室,血液学协同创新中心,苏州215006

出　　处：《中华血液学杂志》2025年第1期70-74,共5页Chinese Journal of Hematology

基　　金：国家自然科学基金(82400275);江苏省自然科学基金资助(BK20230213);国家血液系统疾病临床医学研究中心转化研究课题(2021ZKMA02);江苏高校优势学科建设工程(临床医学)。

摘　　要：目的探索奥妥珠单抗、糖皮质激素为基础的联合方案在复发性免疫性血栓性血小板减少性紫癜(iTTP)患者中的疗效与安全性。方法回顾性分析2023年1月1日至2024年6月30日苏州大学附属第一医院血液内科收治的4例经过奥妥珠单抗、糖皮质激素为基础联合治疗的复发性iTTP患者。结果4例复发iTTP患者均接受过利妥昔单抗和硼替佐米治疗,3例存在其他自身抗体。4例患者经过奥妥珠单抗和糖皮质激素为基础的联合治疗后均获得临床缓解,ADAMTS13活性恢复正常,抑制物转阴。中位随访11(3~17)个月,4例患者均为持续缓解状态。所有患者治疗及随访期间未出现严重不良反应。结论奥妥珠单抗、糖皮质激素为基础的联合方案治疗复发性iTTP具有良好的疗效和安全性。ObjectiveTo evaluate the efficacy and safety of obinutuzumab combined with glucocorticoid-based therapy in patients with relapsed immune thrombotic thrombocytopenic purpura(iTTP).MethodsThis study analyzed the efficacy and adverse reactions of four patients with relapsed iTTP who were treated with a combination of obinutuzumab and glucocorticoids to assess the effectiveness and safety of the treatment.ResultsAll four patients had a history of multiple relapses and had previously undergone treatment with rituximab and bortezomib.Three patients exhibited additional autoantibodies.Following the combined therapy,all patients achieved clinical remission,with ADAMTS13 activity returning to normal levels and inhibitors testing negative.During a median follow-up period of 11 months(range:3–17 months),all patients maintained sustained remission.No severe adverse events were reported during treatment or follow-up.ConclusionThe combination of obinutuzumab and glucocorticoid-based therapy is effective and safe for treating relapsed iTTP.

关 键 词：免疫性血栓性血小板减少性紫癜 复发 奥妥珠单抗 临床缓解 

分 类 号：R558.2[医药卫生—血液循环系统疾病] R554.6[医药卫生—内科学]