Bortezomib in treatment of patients with relapsed/refractory autoimmune hematological disease

Abstract

Relapsed/refractory autoimmune hematological diseases, belong to the thrombus and hemorrhagic disease, are characterized by autoantibody-mediated blood cells or plasma protein destruction caused by the disorder of the immune system, which have poor responses to conventional immunosuppression, including corticosteroids, immunosuppressive agents etc.. Severe illness can endanger the patient′s life and follow-up treatment is difficult. It is still a clinical challenging to explore new treatments to improve the survival rate and long term prognosis of this type of patients. Bortezomib as the only proteasome inhibitor applied to the clinical treatment of tumors has achieved good clinical results in the treatment of multiple myeloma (MM). In addition, proteasome inhibitor such as bortezomib, demonstrating pleiotropic immunomodulatory effects, including inducing apoptosis of plasma cells, influencing process of antigen cells, inhibiting proliferation of autoreactive T cells and reducing expression of inflammatory cytokines. These diverse effects have provided the feasibility for the utility of proteasome inhibitor as a salvage therapy for relapsed/refractory autoimmune hematological diseases. In recent years, some foreign studies have shown that bortezomib can be used as a salvage treatment for patients with relapsed/refractory auto immune hematological diseases. Therefore, the article summarizes the recent research progress of proteasome inhibitor treatment in relapsed/refractory autoimmune hematological diseases. Key words: Bortezomib; Proteasome inhibitor; Relapsed/refractory autoimmune hematological diseases; Autoimmune diseases; Thrombocytopenia