基础医学与临床 ›› 2017, Vol. 37 ›› Issue (10): 1444-1448.

• 临床研究 • 上一篇    下一篇

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

陈苗,庄俊玲   

  1. 北京协和医院
  • 收稿日期:2017-05-08 修回日期:2017-06-30 出版日期:2017-10-05 发布日期:2017-09-25
  • 通讯作者: 庄俊玲 E-mail:zhuangjunling@pumch.cn

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

  • Received:2017-05-08 Revised:2017-06-30 Online:2017-10-05 Published:2017-09-25

摘要: 目的 标准剂量利妥昔单抗(RTX)(375 mg/m2/周x 4)已成为难治复发温抗体型自身免疫性溶血性贫血(wAIHA)的首选二线治疗。尽管如此,低剂量RTX治疗wAIHA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x 4)治疗wAIHA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wAIHA安全有效,不良反应少。

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

Abstract: Objective Standard dose rituximab (375mg/m2/week x 4) has been recommended as salvage regimen for refractory and recurrent warm autoimmune hemolytic anemia (wAIHA). The effect of low-dose rituximab in wAIHA is worth of further study. Method Through a comprehensive literature search through PUBMED and CNKI databases, 13 articles containing 172 cases were included in the systematic review. Result The current understanding of low-dose rituximab in wAIHA 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, re-treatment of low-dose rituximab was still effective in some relapsed patients. No significant adverse events were reported. Conclusion Present literature analysis suggests that low-dose rituximab could be an effective and safe therapy for wAIHA. However, large-sized, prospective, randomized trials are needed to further prove these results.

Key words: warm autoimmune hemolytic anemia, rituximab, anti-CD20 monoclonal antibody, low-dose rituximab

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