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Eur J Haematol. 2010 Oct;85(4):329-34. doi: 10.1111/j.1600-0609.2010.01486.x. Epub 2010 Jul 28.

Low-dose rituximab in adult patients with primary immune thrombocytopenia.

Author information

1
Clinica Ematologica, DIRM, Azienda Ospedaliero Universitaria S. Maria Misericordia, Udine, Italy. zaja.francesco@aoud.sanita.fvg.it

Abstract

BACKGROUNDS:

Rituximab 375 mg/m(2) weekly for 4 wks has significant activity in adults with primary immune thrombocytopenia (ITP). In this setting, several evidences support the possible use of lower doses of rituximab.

OBJECTIVES:

To investigate the activity of low-dose rituximab as salvage therapy in previously treated symptomatic ITP.

METHODS:

Forty-eight adult patients were treated prospectively with rituximab 100 mg weekly for 4 wks.

RESULTS:

Overall and complete responses (CR) (platelet level ≥ 50 and 100 × 10(9) /L) were 60.5% and 39.5%, respectively. In responders, the median time to response was 35 d (range: 7-112 d). The median time of observation was 18 months (range 3-49 months). Sixteen of 29 responding patients (55%) relapsed and 14 needed further treatments. The 12- and 24-month cumulative relapse-free survival was 61% and 45%, respectively. In univariate analysis, CR rate was in inverse relation with weight OR=0.95, CI(95%) [0.91; 0.99] (P=0.019) and age OR=0.96, CI(95%) [0.93; 0.99] (P=0.047). Cox regression model showed that relapse probability increases as weight (HR=1.06, CI(95%) [1.0031; 1.111]) and period between diagnosis and rituximab therapy (HR=1.01, CI(95%) [1.002; 1.017]) increase. One patient developed an interstitial pneumonia 1 month after the end of rituximab treatment. No other infectious, hematologic or extra-hematologic complications were documented during follow-up.

CONCLUSIONS:

Low-dose rituximab is active in ITP but has moderate long-term effect. A comparative study with standard dose is warranted.

[Indexed for MEDLINE]

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