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Am J Hematol. 2009 Oct;84(10):661-5. doi: 10.1002/ajh.21512.

Repeated courses of rituximab in chronic ITP: Three different regimens.

Author information

1
Division of Pediatric Hematology, Children's Blood Center, NY Presbyterian Hospital and Weill Cornell Medical College and Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. hasana@mskcc.org

Abstract

This study investigated responses to retreatment with rituximab in chronic immune thrombocytopenic purpura (ITP) patients. Treatment with rituximab in chronic ITP patients induces long-lasting responses in approximately 30% of patients but even these patients may relapse. Twenty patients who had achieved a response to rituximab and relapsed were retreated with rituximab (375 mg/m(2)x 4); this data was analyzed retrospectively. Subsequently, 16 patients were prospectively randomized to receive rituximab with cyclophosphamide, vincristine and prednisone (R-CVP) or double dose rituximab (DDR). Retreatment with standard dose rituximab demonstrated responses similar to initial rituximab treatment in 15 of 20 patients. Neither of the two more intensive regimens (R-CVP, DDR) induced responses in any patient who had previously failed to respond to rituximab nor induced substantially longer-lasting responses among previous responders. No additional toxicity was noted with the DDR regimen, whereas R-CVP was not well tolerated. These results suggest that retreatment with standard dose rituximab induces similar responses in 75% of previously responding patients and is well tolerated. Neither combining rituximab with CVP nor doubling the dose of rituximab increased the response rate.

PMID:
19731307
PMCID:
PMC2783818
DOI:
10.1002/ajh.21512
[Indexed for MEDLINE]
Free PMC Article

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