The efficacy of rituximab in patients with splenectomized refractory chronic idiopathic thrombocythopenic purpura.

Abstract

The most difficult problem a physician encounters is the management of patients with idiopathic thrombocytopenic purpura (ITP), who has persistent severe thrombocytopenia after failure of initial treatment with glucocorticoids and splenectomy. Most of the patients refractory to corticosteroids and splenectomy will become refractory to other available agents, such as intravenous immunoglobulin (IVIg), danazol or chemotherapy. In this study, we investigated the effect of rituximab on 17 splenectomized refractory chronic ITP patients. Here, we showed that the anti-CD20 antibody, rituximab, induces a clinically significant response in severe chronic ITP patients, who are unresponsive to other therapeutic options. After sixth month, 10 out of 14 responders were still maintaining their durable and significant platelet responses (platelet counts >50 x 10(9)/l), without requirement to any other ITP medication. Therefore, we suggest that, rituximab is an effective treatment option in splenectomized refractory or relapsed ITP patients. Rituximab was well tolerated without severe side effects.

• Authors: Semir Pasa, Abdullah Altintas, Timucin Cil, Ramazan Danis, Orhan Ayyildiz
• Journal: Journal of thrombosis and thrombolysis (J Thromb Thrombolysis) Vol. 27 Issue 3 Pg. 329-33 (Apr 2009) ISSN: 1573-742X [Electronic] Netherlands
• PMID: 18311541 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Rituximab

Topics

• Adult
• Aged
• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Chronic Disease
• Drug-Related Side Effects and Adverse Reactions
• Female
• Humans
• Male
• Middle Aged
• Platelet Count
• Purpura, Thrombocytopenic, Idiopathic (drug therapy)
• Remission Induction (methods)
• Rituximab
• Salvage Therapy (methods)
• Splenectomy
• Treatment Outcome
• Young Adult