利妥昔单抗治疗婴幼儿常规治疗无效的特发性血小板减少性紫癜

目的探讨利妥昔单抗治疗婴幼儿特发性血小板减少性紫癜（ITP）的疗效与安全性。方法利妥昔单抗（375mg／m^2，每周1次，连用4周）治疗2例常规治疗（大剂量丙种球蛋白IVIG、糖皮质激素）无效的婴幼儿（〈3岁）ITP患者，监测治疗前后的血常规、药物副作用，并进行相关文献复习。结果1例微效，1例无效。随访时间均为12周。无不良反应发生。检索11篇有关利妥昔单抗治疗儿童ITP文献，涉及到婴幼儿3例，结合本文共5例婴幼儿病例。1例完全有效，1例微效，3例无效，均无不良反应发生。结论利妥昔单抗治疗常规治疗无效的婴幼儿1TP患者安全，但疗效尚有待进一步证实。

Use of Rituximab in Infant Childhood Immune Thrombocytopenic Purpura Who Useless with Routine Treatment

Objective To discuss the effect and safety of rituximab treatment in infant with immune thrombocytopenic purpura（ITP）. Methods Two useless of routine treatment （IVIG, Steroid） infant patients （〈3y） were given by an intravenous infusion at a dose of 375 mg/m^2 weekly for 4 doses, monitor the platelet number and side effect, review published literatures. Results In these two patients, one achieved a mirror response（MR） ,the other no response （NR）, the time of follow-up long as 12 weeks, no side effect was observed. There are 11 literatures about rituximab treatment in children ITP published, including 3 infant pa- tients. All these 5 patients：one reached CR, one MR, the other three were NR; but none had side effect during and after the treatment. Conclusion Rituximab may be a safe treatment for infant ITP who useless with routine treatment, but the effect must be evaluate further.