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目的探讨利妥昔单抗治疗儿童慢性及难治性免疫性血小板减少症(CITP/RITP)的疗效及安全性。方法收集2010-01-01—2010-12-31首都医科大学附属北京儿童医院血液病中心收治的利妥昔单抗治疗的CITP/RITP病例资料,分析疗效及安全性。结果共收集8例,中位年龄7.8岁(5～11岁),中位观察时间27.6周(14～52周);完全有效3例(37.5%),部分有效3例(37.5%),总有效率75%;均为早期起效,平均起效时间4.2周(3～5周);复发1例(16.7%)。使用中无明显不良反应,1例在结束治疗后3周出现曲霉菌性肺炎,1例在结束治疗后4周出现卡氏肺囊虫肺炎。结论儿童CITP/RITP应用利妥昔单抗治疗有一定疗效。用药中不良反应轻微,用药后需注意深部真菌感染并发症的发生,对近期很少使用丙种球蛋白但较长时间服用较大剂量糖皮质激素、且对利妥昔单抗反应不佳的患儿,需更加注意。
Objective To investigate the efficacy and safety of rituximab in children with chronic and refractory immune thrombocytopenia (CITP / RITP). Methods The data of CITP / RITP patients treated with rituximab in the Hematology Center of Beijing Children’s Hospital affiliated to Capital Medical University from January 2010 to January 2010 were analyzed. The curative effect and safety were analyzed. Results A total of 8 cases were collected. The median age was 7.8 years (range, 5 to 11 years). The median observation time was 27.6 weeks (14-52 weeks). Three cases were completely effective (37.5%) and some were effective The effective rate was 75%. Both of them had early onset, with an average onset time of 4.2 weeks (3-5 weeks) and one case of recurrence (16.7%). There were no significant adverse reactions in use, 1 case of Aspergillus pneumonia occurred 3 weeks after the end of treatment, and 1 case of Pneumocystis carinii pneumonia 4 weeks after the end of treatment. Conclusions Children with CITP / RITP treatment with rituximab have a certain effect. Adverse reactions in medication with minor, medication should pay attention to the occurrence of complications of deep fungal infection, the recent use of gamma globulin rarely, but a longer time to take a larger dose of glucocorticoid, and poor response to rituximab Children, need more attention.