中国药物警戒 ›› 2025, Vol. 22 ›› Issue (12): 1427-1430.
DOI: 10.19803/j.1672-8629.20250309

• 安全与合理用药 • 上一篇    下一篇

奥妥珠单抗注射液联合化疗致急性重度血小板减少症1例分析

陈垚池, 邹东梅, 胡蓉华*, 孙婉玲   

  1. 首都医科大学宣武医院血液科,北京 100053
  • 收稿日期:2025-05-16 发布日期:2025-12-19
  • 通讯作者: *胡蓉华,女,博士,主任医师,恶性血液疾病的诊治。E-mail: huronghua@xwhop.org
  • 作者简介:陈垚池,女,在读硕士,淋巴瘤与白血病。
  • 基金资助:
    首都医学发展科研基金（2022-2-2019）

One Case of Acute Severe Thrombocytopenia Caused by Obinutuzumab Injection Combined with Chemotherapy

CHEN Yaochi, ZOU Dongmei, HU Ronghua*, SUN Wanling   

  1. Department of Hematology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
  • Received:2025-05-16 Published:2025-12-19

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摘要： 目的 探讨奥妥珠单抗注射液联合化疗所致急性重度血小板减少症病例的临床表现及发生机制,提高对该药罕见不良反应的临床警惕性。方法 分析1例61岁男性滤泡淋巴瘤患者使用奥妥珠单抗联合化疗致急性重度血小板减少症病例临床用药过程及血小板变化情况,并对已报道文献进行总结。结果 G-CHOP方案（奥妥珠单抗、环磷酰胺、吡柔比星、长春地辛、强的松）化疗后出现急性重度血小板减少,经关联性评价,予停用奥妥珠单抗并紧急静脉滴注人免疫球蛋白、重组人促血小板生成素及罗普司亭联合治疗后血小板逐渐恢复正常,换用利妥昔单抗后未再出现上述不良反应。结论 首次滴注奥妥珠单抗治疗期间,需密切关注患者血小板计数和是否有出血症状,在骨髓抑制期之前或无骨髓抑制期时出现急性血小板减少症应警惕奥妥珠单抗诱导的急性血小板减少症,需要额外药物警戒和积极风险管理。

关键词: 奥妥珠单抗, 利妥昔单抗, 注射液, 急性血小板减少症, 滤泡淋巴瘤, 药品不良反应

Abstract: Objective To analyze the clinical characteristics and pathogenesis of obinutuzumab injection induced acute severe thrombocytopenia based on real cases in order to improve clinical vigilance on a rare adverse reaction induced by obinutuzumab. Methods The clinical medication for and changes in blood platelets count of a 61-year-old male patient with follicular lymphoma who suffered from acute severe thrombocytopenia caused by the combination of obinutuzumab and chemotherapy were analyzed, and related literature was consulted. Results Acute severe thrombocytopenia occurred following chemotherapy with the G-CHOP regimen (obinutuzumab, cyclophosphamide, pirarubicin, vindesine and prednisone). After causality assessment, obinutuzumab was discontinued. The patient immediately received combined treatment with intravenous immunoglobulins, thrombopoietin, and romiplostim. Subsequently, the platelets count returned to normal. The above adverse reactions did not occur when rituximab replaced obinutuzumab. Conclusion When a patient uses obinutuzumab for the first time, clinicians should care about platelets count and watch for bleeding symptoms. Before bone marrow suppression and in its absence, obinutuzumab-induced acute thrombocytopenia should be taken into consideration in case of acute thrombocytopenia. Pharmacovigilance and risk management are required.

Key words: Obinutuzumab, Rituximab, Injection, Acute Thrombocytopenia, Follicular Lymphoma, Adverse Drug Reaction

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