title: [Efficacy and safety of low-dose rituximab combined with different dosage of glucocorticoids for immune thrombocytopenia].
abstract: OBJECTIVE
  To compare the efficacy and safety of low-dose rituximab combined with different dosage of glucocorticoids for immune thrombocytopenia (ITP).
  
  
  METHODS
  Seventy-four patients (35 male, median age 34 years, range 18-70 years) including 60 newly-diagnosed, 6 persistent, 5 chronic and 3 refractory patients were enrolled in this study, and separated into control (36 cases) and experimental (38 cases) groups according to the dosage of glucocorticoids. Patients in both groups received dexamethasone 40 mg/day on days 1-4, followed by rituximab 100 mg on days 7, 14, 21, 28. The patients in experimental group also received decrements of prednisone 60, 30, 20, 10 mg/day on days 5-7, 8-14, 15-21, 22-28. The initial, long-term efficacy and safety were evaluated.
  
  
  RESULTS
  Platelet counts of all patients at day 4 remarkably increased, with the median platelet count from 11(1-26) × 10⁹/L to 84(23-132) × 10⁹/L in control group, and 10(2-20) × 10⁹/L to 80(22-115) × 10⁹/L in experimental group; the platelet counts of patients at day 14 in experimental group [163(19-262) × 10⁹/L] was higher than that of control group [98(18-238) × 10⁹/L] (P<0.05). The overall response (OR) rates at day 28 in experimental group (84.21%) was significantly higher than that of control group (66.67%, P = 0.03). There was no significant difference of sustained response (SR) rates in two groups (63.89%vs 65.79%, 58.33%vs 60.53%, P > 0.05) at six and twelve months follow-up points. Both groups showed similar incidence of adverse events, and no patients discontinued the treatment due to side effects.
  
  
  CONCLUSIONS
  Low-dose rituximab and glucocorticoids was an effective method for ITP patients, and maintenance treatment with decrements of prednisone contributed to improving earlier CR rate.
authors.affiliation: Department of Hematology, The Affiliated Hospital of Xuzhou Medical College; Transplantation Immunology Laboratory of Xuzhou Medical College, Xuzhou 221002, China.
authors.forename: Wei-wei
authors.initials: WW
authors.lastname: Xing
authors.forename: Zhen-yu
authors.initials: ZY
authors.lastname: Li
authors.forename: Zhi-ling
authors.initials: ZL
authors.lastname: Yan
authors.forename: Kai-ge
authors.initials: KG
authors.lastname: Liu
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Jiang
authors.initials: J
authors.lastname: Cao
authors.forename: Xiu-ying
authors.initials: XY
authors.lastname: Pan
authors.forename: Xu-peng
authors.initials: XP
authors.lastname: He
authors.forename: Kai-lin
authors.initials: KL
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069283:Rituximab; D013921:Thrombocytopenia / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D005938:Glucocorticoids; D000069283:Rituximab