title: Low-dose rituximab for the treatment of acute thrombotic thrombocytopenic purpura: report of four cases.
abstract: OBJECTIVE
  Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder that needs prompt diagnosis and treatment. Front-line therapy consists of plasma exchange (PEx) and steroids, but, in some instances, this is not enough to achieve a complete and sustained response.
  
  
  METHODS
  We report four cases of TTP treated with low-dose rituximab, PEx, and a short course of steroids with an excellent outcome. Three of the patients had primary TTP and another presented an underlying human immunodeficiency virus infection.
  
  
  METHODS
  Rituximab, 100 mg intravenously, was initiated on days 2-8 from the start of PEx as first-line therapy in three cases and as salvage therapy for relapsing disease in one. The number of PEx needed ranged from 5 to 12 sessions. All patients achieved complete remission and are currently asymptomatic, with complete response duration of 8-22 months.
  
  
  CONCLUSIONS
  Treatment of TTP with low-dose rituximab, along with PEx and steroids, seems to be as effective as the standard dose of monoclonal antibody.
authors: Department of Hematology, ‘Dr. José Eleuterio González’ University Hospital of the School of Medicine of Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
authors: Myrna
authors: M
authors: Pequeño-Luévano
authors: Laura
authors: L
authors: Villarreal-Martínez
authors: José Carlos
authors: JC
authors: Jaime-Pérez
authors: Andrés
authors: A
authors: Gómez-de-León
authors: Olga Graciela
authors: OG
authors: Cantú-Rodríguez
authors: Oscar
authors: O
authors: González-Llano
authors: David
authors: D
authors: Gómez-Almaguer
mesh_terms: D000293:Adolescent; D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D010951:Plasma Exchange; D011697:Purpura, Thrombotic Thrombocytopenic / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D000069283:Rituximab; D013256:Steroids / Q000008:administration & dosage*
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D013256:Steroids; D000069283:Rituximab