Journal of Modern OncologyJournal of Modern OncologyСовременная онкология1815-14341815-1442LLC Obyedinennaya Redaktsiya26731ArticlesСтатьиResearch ArticleRituksimab pri lechenii autoimmunnykh tsitopeniy Obzor literaturyРитуксимаб при лечении аутоиммунных цитопений Обзор литературыFilatovL BФилатовЛ БPivnikA VПивникА ВКлинико-диагностический центр, ЕкатеринбургЦИУ Медико-хирургический центр им. Н.И.Пирогова, Москва15062008102NO2 (2008)ТОМ 10, №2 (2008)919709042020Copyright ©; 2008, Consilium MedicumCopyright ©; 2008, ООО "Консилиум Медикум"2008Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc/4.0https://modernonco.orscience.ru/1815-1434/article/view/26731

В последние годы ритуксимаб стал применяться при аутоиммунных процессах: ревматоидном артрите, болезни Шёгрена, системной красной волчанке (СКВ), антифосфолипидном синдроме, аутоиммунных цитопениях и т.д. Механизм действия ритуксимаба при аутоиммунных болезнях основан не только на уменьшении количества В-лимфоцитов и уровня IgG, но и на снижении экспрессии CD40 и CD80 на В-лимфоцитах, что тормозит активацию Т-лимфоцитов. Ритуксимаб может индуцировать элиминацию аутореактивных Т-лимфоцитов и восстанавливать аутотолерантность.

аутоиммунные болезниаутоиммунная цитопенияРитуксимабChambers S.A., Isenberg D. Anti - B cell therapy (Rituximab) in the treatment of autoimmune diseases. Lupus 2005; 14: 210–4.Gottenberg J-E, Guillevin L, Lambotte O et al. Tolerance and short - term efficacy of rituximab in 43 patients with systemic autoimmune diseases. Ann Rheum Dis 2005; 64 (6): 913–20.Garvey B. Rituximab in the treatment of autoimmune haematological disorders. Br J Haemat 2008; 141: 149–69.Edwards J.C.W., Szczepanski L, Szechinski J et al. Efficacy of B - Cell – targeted therapy with rituximab in patients with rheumatoid arthritis. N Engl J Med 2004; 350: 2572–81.Strand V, Balbir-Gurman A, Pavelka K et al. Sustained benefit in rheumatoid arthritis following one course of rituximab: improvements in physical function over 2 years. Rheumatology (Oxford) 2006; 45 (12): 1505–13.Devauchelle-Pensec V, Pennec Y, Morvan J et al. Improvement of Sjogren's syndrome after two infusions of rituximab (anti-CD20). Arthritis Rheum 2007; 57 (2): 310–7.Pijpe J, van Imhoff G.W., Spijkervet F.K.L. et al. Rituximab: treatment in patients with primary Sjogren's syndrome an open - label phase II study. Arthritis & Rheumatism 2005; 52 (9): 2740–50.Lindholm C, Borjesson-Asp K, Zendjanchi K et al. Long - term clinical and immunological effects of anti - CD20 treatment in patients with refractory systemic lupus erythematosus. J Rheumatol 2008; 35 (5): 826–33.Weide R. Successful long - term treatment of systemic lupus erythematosus with rituximab maintenance therapy. Lupus 2003; 12 (10): 779–82.Rubenstein E, Arkfeld D.G., Metyas S et al. Rituximab treatment for resistant antiphospholipid syndrome. J Rheumatol 2006; 33 (2): 355–7.Erre G.L., Pardini S, Faedda R, Passiu G. Effect of rituximab on clinical and laboratory features of antiphospholipid syndrome: a case report and a review of literature. Lupus 2008; 17 (1): 50–55.Narat S, Gandla J, Mehta A.B. Anti-CD20 monoclonal antibody in the treatment of refractory autoimmune cytopenias in adults. Blood (ASH Annual Meeting Abstracts) 2004; 104 (11): abstract 2717.Shanafelt T.D., Madueme H.L., Wolf R.C., Tefferi A. Rituximab for immune cytopenia in adults: idiopathic thrombocytopenic purpura, autoimmune hemolytic anemia, and Evans syndrome. Mayo Clin Proc 2003; 78: 1340–6.Dungarwalla1 M, Marsh1 J, Tooze J et al. Effect of treatment with rituximab in patients with refractory autoimmune cytopenias. Blood (ASH Annual Meeting Abstracts) 2005; 1069 (11): abstract 2405.Tokunaga M, Fujii K, Saito K et al. Down - regulation of CD40 and CD80 on B cells in patients with life - threatening systemic lupus erythematosus after successful treatment with rituximab. Rheumatology (Oxford) 2005; 44 (2): 176–82.Gong Q, Ou Q, Ye Sh et al. Importance of cellular microenvironment and circulatory dynamics in B cell immunotherapy. J Immunol 2005; 174: 817–26.Provan D, Newland A. Fifty years of idiopathic thrombocytopenic purpura (ITP): management of refractory ITP in adults. Br J Haematol 2002; 118: 933–44.Kojouri K, Vesely S.K., Terrell D.R., George J.N. Splenectomy for adult patients with idiopathic thrombocytopenic purpura: a systematic review to assess long - term platelet count responses, prediction of response, and surgical complications. Blood 2004; 104 (9): 2623–34.Tanaka E, Hayashi Sh, Fujimaki K et al. Single dose of anti-CD20 monoclonal antibody (rituximab) treatment in adults with refractory immune thrombocytopenic purpura (ITP). Blood (ASH Annual Meeting Abstracts) 2006; 108 (11): abstract 1077.Stasi R, Provan D. Management of immune thrombocytopenic purpura in adults. Mayo Clin Proc 2004; 79: 504–22.Cines D.B., Bussel J.B. How I treat idiopathic thrombocytopenic purpura. Blood 2005; 106 (7): 2244–51.Vesely S.K., Perdue J.J., Rizvi M.A. et al. Management of adult patients with persistent idiopathic thrombocytopenic purpura following splenectomy. A systematic review. Ann Intern Med 2004; 140:112–20.Ramanarayanan J, Brodzik Fr., Czuczman M.S., Hernandez-Ilizaliturri Fr.J. Efficacy and safety of rituximab in the treatment of refractory/relapsed idiopathic thrombocytopenic purpura: results of a meta - analysis of 299 patients. Blood (ASH Annual Meeting Abstracts) 2006; 108 (11): abstract 1076.Zaja Fr., Battista M.L., Pirrota M.T. et al. Low dose rituximab in adult patients with idiopathic thrombocytopenic purpura. Blood (ASH Annual Meeting Abstracts) 2007; 110 (11): abstract 1305.Kumar S, Diehn F.E., Gertz M.A., Tefferi A. Splenectomy for immune thrombocytopenic purpura: long - term results and treatment of postsplenectomy relapses. Ann Hematol 2002; 81 (6): 312–9.Portielje J.E.A., Westendorp R.G.J., Kluin-Nelemans H.C., Brand A. Morbidity and mortality in adults with idiopathic thrombocytopenic purpura. Blood 2001; 97 (9): 2549–54.Godeau B, Fain O, Porcher R et al. Rituximab is an alternative to splenectomy in adults with chronic immune thrombocytopenic purpura: results of a multicenter prospective phase 2 study. Blood (ASH Annual Meeting Abstracts) 2006; 108 (11): abstract 478.Dabak V, Hanbali A, Kuriakose Ph. Can rituximab replace splenectomy in immune thrombocytopenic purpura (ITP)? Blood (ASH Annual Meeting Abstracts) 2007; 110 (11): abstract 1306.Zaja Fr, Mazza P, Vianelli N et al. A prospective randomized study of rituximab and dexamethasone vs dexamethasone alone in ITP. Blood (ASH Annual Meeting Abstracts) 2007; 110 (11): abstract 567.Braendstrup P, Bjerrum OW, Nielsen OJ et al. Rituximab chimeric anti-CD20 monoclonal antibody treatment for adult refractory idiopathic thrombocytopenic purpura. Am J Hematol 2005; 78 (4): 275–80.Cooper N, Stasi R, Cunningham-Rundles S et al. The efficacy and safety of B-cell depletion with anti-CD20 monoclonal antibody in adults with chronic immune thrombocytopenic purpura. Br J Haematol 2004; 125 (2): 232–9.Santoro Cr, Biondo Fr, de Angelis G et al. Rituximab in refractory idiopathic thrombocytopenic purpura (ITP). Blood (ASH Annual Meeting Abstracts) 2006; 108 (11): abstract 3979.Patel V, Mihatov N, Cooper N et al. Long term follow - up of patients with immune thrombocytopeic purpura (ITP) whose initial response to rituximab lasted a minimum of 1 year. Blood (ASH Annual Meeting Abstracts) 2006; 108 (11): abstract 479.Medeot M, Zaja F, Vianelli N et al. Rituximab therapy in adult patients with relapsed or refractory ITP: long term follow - up results. Eur J Haematol 2008; 28.Zaja Fr, Battista M.L., Pirrotta M.T. et al. Lower dose rituximab is active in adults patients with idiopathic thrombocytopenic purpura. Haematologica 2008; 93 (6): 930–3.Franchini M, Veneri D, Lippi G, Stenner R. The efficacy of rituximab in the treatment of inhibitor - associated hemostatic disorders. Thromb Haemost 2006; 96: 119–25.Arnold D.M., Dentali Fr, Crowther M.A. et al. Systematic review: efficacy and safety of rituximab for adults with idiopathic thrombocytopenic purpura. Ann Intern Med 2007; 146: 25–33.Dierickx D, Mineur Ph, Triffet A et al. Rituximab therapy for autoimmune hemolytic anemia and immune thrombocytopenia: A Belgian Registry. Blood (ASH Annual Meeting Abstracts) 2007; 110 (11): abstract 1737.Garcia-Chavez J, Majluf-Cruz A, Montiel-Cervantes L et al. Rituximab therapy for chronic and refractory immune thrombocytopenic purpura: a long - term follow - up analysis. Ann Hematol 2007; 86: 871–7.Bennet C.M., Rogers Z.R., Kinnamon D.D. et al. Prospective phase 1/2 study of rituximab in childhood and adolescent chronic immune thrombocytopenic purpura. Blood 2006; 107: 2639–42.Burton C, Kaczmarski R, Jan-Mohamed R. Interstitial pneumonitis related to rituximab therapy. N Engl J Med 2003; 348 (26): 2690–1.Swords R, Power D, Fay M et al. Interstitial pneumonitis following rituximab therapy for immune thrombocytopenic purpura (ITP). Am J Hematol 2004; 77 (1): 103–4.Hanbali A, Khaled Y, Ajrouche H et al. Incidence of hepatitis B reactivation in association with rituximab therapy. Blood (ASH Annual Meeting Abstracts) 2006; 108 (11): abstract 2766.Perez-Calvo J.I., Ruiz-Ruiz F, Amores B, Torralba M.A. Long - term costefficacy of rituximab in immune thrombocytopenic purpura. QIM 2005; 98 (11): 839–40.George J.N. Thrombotic thrombocytopenic purpura. N Engl J Med 2006; 354: 1927–35.Terrell D.R., Williams L.A., Vesely S.K. et al. The incidence of thrombotic thrombocytopenic purpura - hemolytic uremic syndrome: all patients, idiopathic patients, and patients with severe ADAMTS-13 deficiency. J Thromb Haemost 2005; 3: 1–5.Matsumoto M, Yagi H, Ishizashi H et al. The Japanese experience of TTP/HUS: analysis of 290 patients. Blood 2003; 102 (11): abstract 2973.Guidelines of the diagnosis and management of the TMHA. Br J Haemat 2003; 120: 556–73.Scully M, Yarranton H, Leisner Ri et al. The South East England Thrombotic Thrombocytopenic Purpura Registry. Blood (ASH Annual Meeting Abstracts) 2006; 108 (11): abstract 1064.George J.N. How I treat patients with thrombotic thrombocytopenic purpura - hemolytic uremic syndrome. Blood 2000; 96 (4): 1223–9.Dervenoulas J, Tsirigotis P, Bollas G et al. Thrombotic thrombocytopaenic purpura/hemolytic uremic syndrome (TTP-HUS): treatment outcome, relapses, prognostic factors. A single - center experience of 48 cases. Ann Hematol 2000; 79 (2): 66–72.Tsai H-M. Von Willebrand factor, ADAMTS13, and thrombotic thrombocytopenic purpura. J Mol Med 2002; 80 (10): 639–47.George J.N. Evaluation and management of patients with clinically suspected thrombotic thrombocytopenic purpura or hemolytic - uremic syndrome/Platelets: thrombotic thrombocytopenic purpura. Hematology 2002; 315–34.Gutterman L.A., Kloster B, Tsai H.M. Rituximab therapy for refractory thrombotic thrombocytopenic purpura. Blood Cells Mol Dis 2002; 28 (3): 385–91.Tsai H-M, Shulman K. Rituximab induces remission of cerebral ischemia caused by thrombotic thrombocytopenic purpura. Eur J Haematol 2003; 70 (3): 183–5.Ahmad A, Aggarwal A, Sharma D et al. Rituximab for treatment of refractory/relapsing thrombotic thrombocytopenic purpura (TTP). Am J Hematol 2004; 77 (2): 171–6.Reddy P.S. et al. Rituximab in the treatment of relapsed thrombotic thrombocytopenic purpura. Ann Hematol 2005; 84 (4): 232–5.Zheng X, Pallera A.M., Goodnough L.T. et al. Remission of chronic thrombotic thrombocytopenic purpura after treatment with cyclophosphamide and rituximab. Ann Intern Med 2003; 138 (2): 105–8.Franchini M, Veneri D, Lippi G, Stenner R. The efficacy of rituximab in the treatment of inhibitor - associated hemostatic disorders. Thromb Haemost 2006; 96: 119–25.Fakhouri F, Vernant J-P, Veyradier A et al. Efficiency of curative and prophylactic treatment with rituximab in ADAMTS13 deficient - thrombotic thrombocytopenic purpura: a study of 11 cases. Blood 2005; 106 (6): 1932–7.Fachouri F, Deroure B, Hummel A. A new treatment for TTP? Nephrol Dial Transplant 2006; 21: 577–9.Scully M, Cohen H, Cavenagh J et al. Remission in acute refractory and relapsing thrombotic thrombocytopenic purpura following rituximab is associated with a reduction in IgG antibodies to ADAMTS-13. Br J Haematol 2007; 136 (3): 451–61.Scully M, Starke R, Mackie I, Machin S.J. Acute idiopathic thrombotic thrombocytopenic purpura: predicting relapse and response to treatment. Blood (ASH Annual Meeting Abstracts) 2006; 108 (11): abstract 1059.von Auer Ch, Hess G, Scharrer I. Prevention of complete TTP relapses by immediate initiation of rituximab treatment. Blood 2007; 110 (11): abstract 3203.Scully M, Cavenagh J, Hunt B et al. A Phase II study to assess the safety, efficacy and tolerability of rituximab in combination with plasma exchange in patients with acute idiopathic thrombotic thrombocytopenic purpura. Blood 2007; 110 (11): abstract 1303.Thirunavu M, Deauna-Limayo D, Patel J et al. Rituximab treatment affords long term control in thrombotic thrombocytopenic purpura (TTP): The University of Kansas Experience. Blood (ASH Annual Meeting Abstracts) 2006; 108 (11): abstract 1055.Scully M.A., Liesner R, Cavenagh J et al. Rituximab in the treatment of acute refractory and chronic relapsing thrombotic thrombocytopenic purpura: results from 28 patients. Haematologica/Hematol J 2006; 91 (s1): abstract 514.Gehrs Br.C., Friedberg R.C. Autoimmune hemolytic anemia. Am J Hematology 2002; 69: 258–71.Cabrera J.R., Penalver F.J., Millan I et al. Mabthera (Rituximab) in the treatment of 34 adult patients with refractory autoimmune hemolytic anemia (AIHA). Blood (ASH Annual Meeting Abstracts) 2004; 104 (11): abstract 1619.McDevitt P.W., Fichtner R, Frame J.N. Rituximab for the treatment of autoimmune hemolytic anemia in adults: An analysis of literature reports in 92 patients. Blood (ASH Annual Meeting Abstracts) 2004; 104 (11): abstract 3721.Gupta N, Kavuru S, Patel D et al. Rituximab–based chemotherapy for steroid – refractory autoimmune hemolytic anemia of chronic lymphocytic leukemia. Leukemia 2002; 16 (10): 2092–5.Shanafelt T.D., Madueme H.L., Wolf R.C., Tefferi A. Rituximab for immune cytopenia in adults: idiopathic thrombocytopenic purpura, autoimmune hemolytic anemia, and Evans syndrome. Mayo Clin Proc 2003; 78: 1340–6.Narat S, Gandla J, Hoffbrand A.V. et al. Rituximab in the treatment of refractory autoimmune cytopenias in adults. Haematologica 2005; 90: 1273–4.D'Arena G, Califano C, Annunziata M et al. Rituximab for warm - type idiopathic autoimmune hemolytic anemia: a retrospective study of 11 adult patients. Eur J Haematol 2007; 79 (1): 53–8.Berentsen S, Ulvestad B, Gjertsen B.T. et al. Rituximab for primary chronic cold agglutinin disease: a prospective study of 37 courses of therapy in 27 patients. Blood 2004; 103: 2925–8.Berentsen S, Ulvestad E, Langholm R et al. Primary chronic cold agglutinin disease: a population based clinical study of 86 patients. Haematologica 2006; 91: 460–6.Schollkopf C, Kjeldsen L, Bjerrum O/W/ et al. Rituximab in chronic cold agglutinin disease: a prospective study of 20 patients. Leuk lymphoma 2006; 47 (2): 253–60.Arriaga F, Jarque I, Paciello M-L et al. Rituximab monotherapy for cold agglutinin disease. Report on 16 patients from a single institution. Blood (ASH Annual Meeting Abstracts) 2006; 108 (11): abstract 965.Gertz M.A. Cold hemolytic syndrome. Hematology 2006; 18–23.Sailler L. Rituximab off label use for different - to - treat autoimmune diseases: reappraisal of benefits and risks. Clin Rev Allergy Immunol 2008; 34 (1): 103–10.