[Rituximab treatment of chronic idiopathic thrombocytopenic purpura. Results of a phase II study].
In a recent article we indicated that rituximab is an active and safe drug in patients with chronic ITP. We report now the updated results of this study. Twenty-five individuals with chronic ITP were treated with intravenous rituximab at the dose of 375 mg/m2 once weekly for 4 weeks. Rituximab infusion-related side effects were observed in 18 patients, but they were of modest intensity and did not require discontinuation of treatment. Long-term side effects included a decreased B-cell count of several months duration in most patients which, however, did not translate into a significant rate of infections. The overall response rate was 52%, with 7 cases showing a sustained response (6 months or longer). In 2 patients with relapsed disease, repeat challenge with rituximab induced a new response. In responders a significant rise in platelet concentrations was observed early during the course of treatment, usually 1 week after the first rituximab infusion. No clinical or laboratory parameter was found to predict treatment outcome. In conclusion, we confirm that rituximab can induce long-lasting responses in patients with chronic ITP and has a favorable side effect profile. Therefore, we suggest its use in refractory ITP cases.
Dipartimento di Ematologia, Ospedale S. Eugenio, Università Tor Vergata, Roma. p.meo@tiscali.it
Paola
P
Meo
Elisa
E
Stipa
Michele
M
La Presa
Massimo
M
Bianchi
Claudio
C
Di Giulio
Roberto
R
Stasi
Sergio
S
Amadori
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D002908:Chronic Disease; D003176:Complement C3 / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D000069283:Rituximab; D013997:Time Factors
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D003176:Complement C3; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D000069283:Rituximab