title: High response rate to low-dose rituximab plus high-dose dexamethasone as frontline therapy in adult patients with primary immune thrombocytopenia.
abstract: Corticosteroids as initial therapy for primary immune thrombocytopenia achieve a low rate of sustained remission.
  
  
  METHODS
  We prospectively evaluated the efficacy, safety, and response duration of low-dose rituximab plus high-dose dexamethasone as frontline therapy in newly diagnosed primary immune thrombocytopenia patients. One cycle of dexamethasone, 40 mg/d/intravenously for four consecutive days, plus weekly intravenous rituximab, 100 mg for four doses, was delivered.
  
  
  RESULTS
  Twenty-one consecutive adults were enrolled. The overall response at day +28 was 90.5%. Complete sustained response at 6 months and relapse rate were 76.2% and 15.8%, respectively, compared with 30% and 62.5% for a historical group who had received standard treatment with prednisone (P = 0.005 and P = 0.004). There was a 9.5% incidence of adverse effects.
  
  
  CONCLUSIONS
  The combination of low-dose rituximab and high-dose dexamethasone as frontline therapy for adults with primary immune thrombocytopenia was effective and had a high overall response rate and a low incidence of relapse.
authors.affiliation: Hematology Service, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, México. dr_gomez@infosel.net.mx
authors.forename: David
authors.initials: D
authors.lastname: Gómez-Almaguer
authors.forename: Luz
authors.initials: L
authors.lastname: Tarín-Arzaga
authors.forename: Brizio
authors.initials: B
authors.lastname: Moreno-Jaime
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Jaime-Pérez
authors.forename: Adrián Alejandro
authors.initials: AA
authors.lastname: Ceballos-López
authors.forename: Guillermo J
authors.initials: GJ
authors.lastname: Ruiz-Argüelles
authors.forename: Guillermo J
authors.initials: GJ
authors.lastname: Ruiz-Delgado
authors.forename: Olga Graciela
authors.initials: OG
authors.lastname: Cantú-Rodríguez
authors.forename: Cesar Homero
authors.initials: CH
authors.lastname: Gutiérrez-Aguirre
authors.forename: Mónica
authors.initials: M
authors.lastname: Sánchez-Cárdenas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage* / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy*; D012008:Recurrence; D000069283:Rituximab
chemical_list: D000893:Anti-Inflammatory Agents; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab; D003907:Dexamethasone