在瑞图西马布治疗自身免疫和淋巴细胞疾病后,持续的B细胞枯竭:一系列病例
Orhan Efe1,2,3, Gabriel Sauvage1, Anushya Jeyabalan1,2,3
1Vasculitis and Glomerulonephritis Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
Kidney international reports
|June 9, 2025
概括
在Rituximab治疗后持续的B细胞枯竭是罕见的,影响2%的患者,并与延长缓解,但增加感染风险有关. 大多数患者没有恢复B细胞,有些人死于慢性疾病并发症.
科学领域:
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 利图西马布是一种单克隆抗体,用于治疗各种自身免疫和血液疾病.
- 持续的B细胞枯竭是一种罕见的,缺乏理解的Rituximab治疗并发症.
研究的目的:
- 在患有淋巴细胞和自身免疫性疾病的患者中,研究Rituximab治疗后持续的B细胞枯竭的临床含义和特征.
主要方法:
- 一个回顾1519名患者的病例系列,他们接受了Rituximab治疗.
- 鉴定了患有持续的B细胞枯竭的患者 (<5个CD19+CD20+细胞/μl>2年).
- 分析了患者的人口统计,先前的治疗,疾病结果和并发症.
主要成果:
- 2% (30/1519) 的患者患有持续的B细胞枯竭,特别是那些患有ANCA相关血管炎的患者.
- 只有30%的患者在4年内表现出B细胞重组,数量非常低.
- 在83%的患者中观察到持续的疾病缓解,但47%的患者经历了复发性感染和57%的严重感染.
结论:
- 持久性B细胞枯竭是一种罕见的rituximab并发症,通常在患者之前接触过细胞毒性治疗时见到.
- 这种情况与长时间的疾病缓解有关,但显著增加了感染的风险.
- 观察到死亡率,主要是由于潜在的慢性疾病的并发症.
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