美罗华联合CHOP方案治疗侵袭性B细胞淋巴瘤

目的:探讨美罗华联合CHOP方案治疗侵袭性B细胞淋巴瘤疗效。方法:选取患者102例,采用数字表法分为常规组和联合组,分别给予CHOP方案和美罗华联合CHOP方案治疗,评价其治疗有效率和不良反应率。结果:联合组治疗有效性(88.24%)高于常规组(66.67%)(P0.05);两组不良反应率(21.57%vs25.49%)差异对比无统计学意义(P0.05)。结论:美罗华联合CHOP方案治疗侵袭性B细胞淋巴瘤相比于常规方案,在不增加患者不良反应率的前提下,可提高患者症状缓解率。     

Bilateral Orbital IgG4-Related Disease with Systemic and Corneal Involvement Showing an Excellent Response to Steroid and Rituximab Therapy: Report of a Case with 11 Years Follow-Up

IgG4-related disease is a newly recognized fibro-inflammatory condition. The purpose of this report is to present a patient with 11 years of follow-up, who revealed characteristic features of IgG4-related disease with systemic, orbital and corneal involvement and showed a favorable response to steroids and rituximab treatment.     

小剂量美罗华联合重组人血小板生成素治疗难治性特发性血小板减少性紫癜的护理

目的探讨小剂量美罗华联合重组人血小板生成素(rh TPO)治疗难治性特发性血小板减少性紫癜(ITP)的疗效及其护理。方法对诊断为难治性ITP的4例患者采用小剂量美罗华联合rh TPO治疗,治疗过程中实施有效的心理护理,严格规范药液的保管、配置及输注,积极预防和处理药物不良反应,并对副作用进行严密观察和护理。结果 4例患者中,1例获完全反应(CR),3例获部分反应(PR),发热1例、肝功能异常1例,所有患者均顺利完成治疗。结论小剂量美罗华联合rh TPO为难治性ITP的治疗提供了新途径,是一种安全有效的治疗方法,精心的护理能有效预防药物的毒副作用,保证治疗效果。     

CD20 monoclonal antibodies for the treatment of multiple sclerosis: up-to-date

Introduction: Featuring demyelination and axonal degeneration, multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system representing a prominent cause of disability in young adults. The recently established therapeutic targeting of B cells in MS patients using CD20 monoclonal antibodies (CD20-mAbs) not only profoundly suppresses inflammatory disease activity but also materializes as the first treatment approach against disability accumulation in a subset of patients with primary progressive MS.

Areas covered: We will review current concepts regarding the immunopathology of B cells as well as results of clinical trials with CD20-mAbs in MS, from the murine-human chimeras rituximab and ublituximab to their increasingly humanized counterparts ocrelizumab and ofatumumab. We conducted a literature search using PubMed, clinicaltrials.gov, and clinicaltrialsregister.eu. We will focus on studies emphasizing the effectiveness of these mAbs in reducing MS disease activity and progression, long-term safety, optimal dosage and maintenance regimens. Lastly, we will turn to outstanding questions regarding anti-CD20 therapy in MS.

Expert opinion: CD20-mAbs could become first-line drugs in selected patients with highly active MS and already constitute an option for PPMS. Future studies could evaluate whether administration regimens currently in use can be optimized, while registry data could shed light on risk versus benefits on the long run, considering immunosenescence and a potentially increased risk of malignancies and infections in an aging population.     

Treatment of the inflammatory myopathies: update and practical recommendations

Background: The inflammatory myopathies are a heterogeneous group of diseases including dermatomyositis, polymyositis, and inclusion body myositis. Clinical trials in myositis are rare, making it difficult to make clear recommendations on the treatment of these rare disorders. Objective: To give an overview of treatment options and strategies and to provide the clinician with a framework that can be used in treating patients with myositis. Methods: Results of clinical trials in myositis, case series and important case reports are presented and discussed. Results/conclusion: Most patients with dermatomyositis or polymyositis require treatment with oral high-dose prednisone combined with azathioprine or methotrexate to facilitate early tapering of prednisone. In case of treatment failure, intravenous immunoglobulin can be tried, followed by rituximab, mycophenolate mofetil, or tacrolimus depending on the specific clinical situation. A treatment trial with oral prednisone combined with methotrexate is advised in a subgroup of patients with inclusion body myositis.     

An update on the management of chronic lymphocytic leukaemia

Despite the lack of long-term survival data, the impressive results obtained with fludarabine- and rituximab-based therapies have altered the philosophy of the management of patients with chronic lymphocytic leukaemia (CLL). Therapy with chemoimmunotherapy appears to give higher responses with more patients achieving complete remission and some molecular remission. This may potentially translate into improved disease-free survival, and potentially a ‘cure’. Treatment options for patients who develop resistance to fludarabine continue to be limited. This review summarises current chemo-, immuno-, and chemoimmunotherapeutic regimens that are being currently evaluated in patients with CLL.