特发性血小板减少性紫癜的诊治进展

由于诊断特发性血小板减少性紫癜(ITP)的标准差异较大,使临床试验结果难以互比,也给临床实践带来不便.为解决此问题,ITP国际工作组于2007年召开会议,就ITP的命名、定义、分期以及严重度分级、预后和疗效标准等达成一些新共识.随着新的治疗药物问世,ITP治疗也取得显著进步.利妥昔单抗是一种抗CD20单克隆抗体,可清除能产生自身抗体的B淋巴细胞,因其疗效高和安全性好,现已在ITP中广为应用.最近研究表明,血小板生成减少可能与ITP发生有关.因此,新的血小板生成刺激剂,如血小板生成素受体激动剂Romiplostim和Eltrombopag已成为治疗ITP的新选择.

Advances in Diagnosis and Treatment of Idiopathic Thrombocytopenic Purpura

The diversity of diagnostic criteria of idiopathic thrombocytopenic purpura (ITP) makes it difficult to compare clinical trial results and exchange clinical experiences. To address this issue, an ITP international working group convened a consensus conference in Italy in October 2007, and some new consensuses concerning the terminology, definition, phases, grading of severity, prognosis, and treatment were achived. The treatment of ITP has been dramatically improved along with the introduction of novel therapeutic agents. Rituximab, a monoclonal anti-CD20 antibody that is able to deplete autoantibody-producing B lymphocytes, has been widely applied because of its high efficacy and safety. Recent evidences suggest that decreased platelet production may also contribute to the development of ITP. Therefore, novel thrombopoiesis-stimulating agents such as thrombopoietin-receptor agonists Romiplostim and Eltrombopag have become new therapeutic options for ITP.