利妥昔单抗治疗难治性原发免疫性血小板减少症的研究进展

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摘要原发免疫性血小板减少症（ITP）是一种免疫介导的获得性血小板减少所致的出血性疾病，对于进行诊断再评估仍确诊为ITP、脾切除无效或术后复发的ITP称为难治性ITP。由于发病机制复杂，目前临床上难治性ITP尚无统一的治疗方案。利妥昔单通过杀伤功能异常的B淋巴细胞，缓解血小板破坏从而对ITP起到良好的治疗作用。文章从利妥昔单抗治疗难治性ITP的作用机制、临床方案及疗效研究等方面进行综述，以期促进利妥昔单抗在难治性ITP治疗中的进一步研究。

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	黄子明李蕊白侯丽张雅月

关键词 ：原发免疫性血小板减少症, 难治性, 利妥昔单抗, 综述

Abstract：Primary immunologic thrombocytopenic purpura (ITP) is a hemorrhagic disease caused by immune-mediated acquired thrombocytopenia, and it is called refractory ITP if ITP is still confirmed as ITP after diagnosis and reassessment, ineffective ITP with splenectomy or postoperative recurrence. Due to the complicated pathogenesis, there is currently no unified treatment plan for clinically refractory ITP. Rituximab has a good therapeutic effect on ITP by killing abnormal B lymphocytes and alleviating platelet destruction. This article reviews the mechanism of action, clinical program, and efficacy of Rituximab in the treatment of refractory ITP, with a view to promoting further research of Rituximab in the treatment of refractory ITP.

Key words： Primary immunologic thrombocytopenic purpura Refractory Rituximab Review

基金资助:国家自然科学基金青年科学基金项目（8170390 3）；
北京中医药大学东直门医院青苗人才培养计划项目（DZMYS-201807）。

通讯作者: 张雅月（1982.6-），女，博士，副主任医师；研究方向：中西医结合防治血液病。

作者简介: 黄子明（1995.10-），男，北京中医药大学第一临床医学院2019级中西医结合临床专业在读硕士研究生；研究方向：中西医结合防治血液病。

引用本文:

黄子明李蕊白侯丽张雅月. 利妥昔单抗治疗难治性原发免疫性血小板减少症的研究进展[J]. 中国医药导报, 2020, 17(33): 38-41.
HUANG Ziming LI Ruibai HOU Li ZHANG Yayue. Research progress of Rituximab in the treatment of refractory primary immunologic thrombocytopenic purpura. 中国医药导报, 2020, 17(33): 38-41.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I33/38

[1] 中华医学会血液学分会止血与血栓学组.成人原发免疫性血小板减少症诊断与治疗中国专家共识（2016年版）[J].中华血液学杂志，2016，37（2）：89-93.
[2] 滕志，雷秦，许世娟，等.利妥昔单抗治疗难治性特发性血小板减少性紫癜患者临床研究[J].陕西医学杂志，2019， 48（1）：102-104.
[3] Cardiel MH，Carrillo S，Pérez M，et al. Update of the Mexican College of Rheumatology Guidelines for the Pharmacological Treatment of Rheumatoid Arthritis，2018 [J]. Reumatol Clin，2019，S1699-258X（19）：30079-30078.
[4] Fanouriakis A，Kostopoulou M，Alunno A，et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus [J]. Ann Rheum Dis，2019，78（6）：736-745.
[5] Wierda WG，Byrd JC，Abramson JS，et al. Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma，Version 4.2020，NCCN Clinical Practice Guidelines in Oncology [J]. J Natl Compr Canc Netw，2020，18（2）：185-217.
[6] Robak T. Emerging monoclonal antibodies and related agents for the treatment of chronic lymphocytic leukemia [J]. Future Oncol，2013，9（1）：69-91.
[7] Paul F，Cartron G. Infusion-related reactions to rituximab：frequency，mechanisms and predictors [J]. Expert Rev Clin Immunol，2019，15（4）：383-389.
[8] Gil’deeva GN，Kudlai DA，Luk’yanov SV. THE MECHANISMS OF ACTION OF RITUXIMAB[J]. Eksp Klin Farmakol，2015，78（12）：51-56.
[9] Reboursiere E，Fouques H，Maigne G，et al. Rituximab salvage therapy in adults with immune thrombocytopenia： retrospective study on efficacy and safety profiles [J]. Int J Hematol，2016，104（1）：85-91.
[10] Li Y，Shi Y，He Z，et al. The efficacy and safety of low-dose rituximab in immune thrombocytopenia： a systematic review and meta-analysis [J]. Platelets，2019，30（6）：690-697.
[11] 童勇，冯春，杜飞，等.不同剂量利妥昔单抗注射液治疗难治性免疫性血小板减少症的疗效及对凝血指标的影响[J].中国医学创新，2018，15（10）：13-16.
[12] Tran H，Brighton T，Grigg A，et al. A multi-centre，single-arm，open-label study evaluating the safety and efficacy of fixed dose rituximab in patients with refractory，relapsed or chronic idiopathic thrombocytopenic purpura（R-ITP1000 study）[J]. Br J Haematol，2014，167（2）：243-251.
[13] Mahévas M，Ebbo M，Audia S，et al. Efficacy and safety of rituximab given at 1000 mg on days 1 and 15 compared to the standard regimen to treat adult immune thrombocytopenia [J]. Am J Hematol，2013，88（10）：858-861.
[14] Stasi R，Pagano A，Stipa E，et al. Rituximab chimeric anti-CD20 monoclonal antibody treatment for adults with chronic idiopathic thrombocytopenic purpura [J]. Blood，2001，98（4），952-957.
[15] British Committee for Standards in Haematology General Haematology Task Force. Guidelines for the investigation and management of idiopathic thrombocytopenic purpura in adults，children and in pregnancy [J]. Br J Haematol，2003，120（4）：574-596.
[16] Chugh S，Darvish-Kazem S，Lim W，et al. Rituximab plus standard of care for treatment of primary immune thrombocytopenia： a systematic review and meta-analysis [J]. Lancet Haematol，2015，2（2）：e75-e81.
[17] Patel VL，Mahévas M，Lee SY，et al. Outcomes 5 years after response to rituximab therapy in children and adults with immune thrombocytopenia [J]. Blood，2012，119（25）：5989-5995.
[18] Zhou Z，Yang R. Rituximab treatment for chronic refractory idiopathic thrombocytopenic purpura [J]. Crit Rev Oncol Hematol，2008，65（1）：21-31.
[19] Ghanima W，Khelif A，Waage A，et al. Rituximab as second-line treatment for adult immune thrombocytopenia （the RITP trial）：a multicentre，randomised，double-blind，placebo-controlled trial [J]. Lancet，2015，385（9978）：1653-1661.
[20] 桑宝华.利妥昔单抗对儿童难治性ITP的疗效观察[J].世界最新医学信息文摘，2019，19（11）：109.
[21] Hindilerden F，Y?觟nal-Hindilerden ■，Yenerel MN，et al. Rituximab Therapy in Adults with Refractory Symptomatic Immune Thrombocytopenia： Long-Term Follow-Up of 15 Cases [J]. Turk J Haematol，2017，34（1）：72-80.
[22] Hammond WA，Vishnu P，Rodriguez EM，et al. Sequence of Splenectomy and Rituximab for the Treatment of Steroid-Refractory Immune Thrombocytopenia：Does It Matter? [J]. Mayo Clin Proc，2019，94（11）：2199-2208.
[23] Wang J，Wang B，Sun Z，et al. Therapeutic effects of rituximab combined with cyclophosphamide on refractory idiopathic thrombocytopenic purpura [J]. Exp Ther Med，2019，17（3）：2137-2142.
[24] Lambert MP，Gernsheimer TB. Clinical updates in adult immune thrombocytopenia [J]. Blood，2017，129（21）：2829-2835.
[25] Hoofnagle JH，Dusheiko GM，Schafer DF，et al. Reactivation of Chronic Hepatitis B Virus Infection by Cancer Chemotherapy [J]. Ann Intern Med，1982，96（4）：447-449.
[26] Nomura S. Advances in Diagnosis and Treatments for Immune Thrombocytopenia [J]. Clin Med Insights Blood Disord，2016，9：15-22.
[27] Vendramin C，Thomas M，Westwood JP，et al. Rituximab-induced acute and delayed serum sickness in thrombotic thrombocytopenic purpura： the role of anti-rituximab antibodies [J]. Br J Haematol，2019，184（5）：858-861.
[28] Deshayes S，Khellaf M，Zarour A，et al. Long-term safety and efficacy of rituximab in 248 adults with immune thrombocytopenia： Results at 5 years from the French prospective registry ITP-ritux [J]. Am J Hematol，2019， 94（12）：1314-1324.
[29] Ghanima W，Godeau B，Cines DB，et al. How I treat immune thrombocytopenia： the choice between splenectomy or a medical therapy as a second-line treatment [J]. Blood，2012，120（5）：960-969.
[30] Arnold DM，Dentali F，Crowther MA，et al. Systematic review： efficacy and safety of rituximab for adults with idiopathic thrombocytopenic purpura [J]. Ann Intern Med，2007，146（1）：25-33.
[31] 车蕾，周泽平.多药联合治疗ITP的进展[J].中国免疫学杂志，2019，35（8）：999-1002.