Semin Arthritis Rheu:B细胞消除治疗原发性抗磷脂综合征严重血小板减少的长期疗效

2018-04-16 xiangting MedSci原创

对于常规治疗不耐受或难治的严重血小板减少PAPS患者,单用RTX可使患者达到持续临床缓解,而不需要免疫抑制维持治疗。

这项研究旨在探讨单用利妥昔单抗(RTX)消除B细胞疗法作为原发性抗磷脂综合征(PAPS)患者严重血小板减少挽救疗法的长期疗效。

研究人员回顾性检索了符合以下纳入标准的患者数据:a)持续aPL阳性并满足PAPS悉尼标准;b)出现严重血小板减少症(血小板<50.000/mm3);c)用RTX作为挽救疗法;d)在B细胞消除治疗后至少随访1年。

这项回顾性研究纳入6名出现严重血小板减少症(血小板<50.000/mm3,平均值为31.000±9.000/mm3)的女性PAPS患者[平均年龄49.5岁(范围38-66岁)]。6名患者中有5名(83.3%)使用RTX治疗后达到完全反应(定义为>150.000个血小板/mm3)。在反应者中,超过4年的中位随访后,中位无复发时间为43个月(范围12-97)。1名患者B细胞消除治疗无效,在RTX治疗后1个月行脾切除术,3个月后血小板水平恢复正常。无不良事件,没有患者出现严重感染。重要的是,患者不需要针对血小板减少症的进一步维持治疗。

在最长的观察性研究(中位数43个月)中,对于常规治疗不耐受或难治的严重血小板减少PAPS患者,单用RTX可使患者达到持续临床缓解,而不需要免疫抑制维持治疗。

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    2018-04-18 zhaojie88
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    2018-04-18 zhouqu_8
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    2018-04-16 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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