托珠单抗治疗造血干细胞移植后大量心包积液2例报告

doi:10.12372/jcp.2024.23e0861

摘要/Abstract

摘要：

探讨白介素-6受体单抗（托珠单抗）治疗造血干细胞移植后并发糖皮质激素难治/复发性大量心包积液的疗效和安全性。回顾分析2例重型β-地中海贫血患儿造血干细胞移植后并发大量心包积液的临床资料、诊治过程和结局。1例心包积液为糖皮质激素难治性，1例为复发性，给予托珠单抗治疗后心包积液均迅速缓解，无明显不良反应，缩短了糖皮质激素疗程，且后期随访未见心包积液反复。托珠单抗可作为造血干细胞移植后并发糖皮质激素难治性或复发性大量心包积液的二线选择。

关键词: 造血干细胞移植, 心包积液, 白介素-6, 托珠单抗

Abstract:

To explore the efficacy and safety of interleukin-6 receptor monoclonal antibody (tocilizumab) in patients with glucocorticoid-resistant/recurrent massive pericardial effusion after hematopoietic stem cell transplantation. The clinical data, diagnosis, treatments, and outcomes of 2 children with β-thalassemia major complicated by massive pericardial effusion after hematopoietic stem cell transplantation were analyzed retrospectively. One case of pericardial effusion was glucocorticoid-resistant and 1 case was recurrent. The pericardial effusion was resolved rapidly after administration of tocilizumab without significant adverse effects, the course of glucocorticoid therapy was shortened, and there was no recurrence of pericardial effusions during subsequent follow-up. Tocilizumab may be considered as a second-line option for patients with glucocorticoid-resistant or recurrent massive pericardial effusion after hematopoietic stem cell transplantation.

Key words: hematopoietic stem cell transplantation, pericardial effusion, interleukin-6, tocilizumab

李越, 周小辉, 王晓东, 杨春兰, 王春静, 张瑜, 刘四喜. 托珠单抗治疗造血干细胞移植后大量心包积液2例报告[J]. 临床儿科杂志, 2024, 42(7): 595-599.

LI Yue, ZHOU Xiaohui, WANG Xiaodong, YANG Chunlan, WANG Chunjing, ZHANG Yu, LIU Sixi. Successful treatment of massive pericardial effusion after hematopoietic stem cell transplantation with tocilizumab: two cases report[J]. Journal of Clinical Pediatrics, 2024, 42(7): 595-599.

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