title: Rituximab in immune thrombocytopenia: gender, age, and response as predictors of long-term response.
abstract: OBJECTIVE
  To evaluate the efficacy of a salvage treatment with rituximab (RTX) in adults with primary immune thrombocytopenia (ITP), in terms of short-term response and long-term response (LTR, i.e., probability to achieve and maintain response) and to identify biological and clinical predictors of response.
  
  
  METHODS
  We retrospectively evaluated the outcome of patients with primary ITP treated with standard dosage RTX (375 mg/m2× 4) as salvage therapy in five Italian centers. One hundred and three patients, median age of 46 yr, were included. The median period of observation was 59 months.
  
  
  RESULTS
  Response (R) and complete response (CR) were documented in 57 (55%) and 37 (36%) patients, respectively. Patients younger than 40 yr had a higher probability to achieve CR (P = 0.025). Younger women (age < 40 yr) had a significantly higher probability to achieve R and CR (P = 0.039 and P = 0.009, respectively). The estimated LTR rate was 36% and 31% after 48 and 72 months, respectively; female sex (P = 0.033) and younger age (P = 0.021) were associated with better LTR. Younger women had the highest LTR rate (P = 0.006). Response duration was associated with the obtainment of CR after RTX (CR vs. partial response, P = 0.002).
  
  
  CONCLUSIONS
  The effect of RTX salvage treatment appears higher in younger women, with LTR rate possibly approaching that of splenectomy.
authors.affiliation: Institute of Hematology L.A. Seragnoli, University of Bologna, Bologna, Italy.
authors.forename: Miriam
authors.initials: M
authors.lastname: Marangon
authors.affiliation: Institute of Hematology L.A. Seragnoli, University of Bologna, Bologna, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Vianelli
authors.affiliation: Institute of Hematology L.A. Seragnoli, University of Bologna, Bologna, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Palandri
authors.affiliation: Ematologia, Dipartimento di Biotecnologie Cellulari ed Ematologia, Università Sapienza, Roma, Italy.
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Mazzucconi
authors.affiliation: Ematologia, Dipartimento di Biotecnologie Cellulari ed Ematologia, Università Sapienza, Roma, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Santoro
authors.affiliation: UO Oncoematologia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Wilma
authors.initials: W
authors.lastname: Barcellini
authors.affiliation: UO Oncoematologia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Fattizzo
authors.affiliation: Department of Hematology, Azienda Sanitaria Universitaria Integrata S. Maria della Misericordia, Udine, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Volpetti
authors.affiliation: Department of Hematology, Azienda Sanitaria Universitaria Integrata S. Maria della Misericordia, Udine, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Lucchini
authors.affiliation: Institute of Hematology L.A. Seragnoli, University of Bologna, Bologna, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Polverelli
authors.affiliation: U.O.C Ematologia e Trapianto, ASST Ospedale San Gerardo, Monza, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Carpenedo
authors.affiliation: Chair of Statistics, DIRM, Università degli Studi di Udine, Udine, Italy.
authors.forename: Miriam
authors.initials: M
authors.lastname: Isola
authors.affiliation: Department of Hematology, Azienda Sanitaria Universitaria Integrata S. Maria della Misericordia, Udine, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Fanin
authors.affiliation: Department of Hematology, Azienda Sanitaria Universitaria Integrata S. Maria della Misericordia, Udine, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Zaja
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy* / Q000401:mortality; D000069283:Rituximab / Q000008:administration & dosage*; D016879:Salvage Therapy; D012737:Sex Factors; D013997:Time Factors
chemical_list: D000069283:Rituximab
keywords: hemostaseology and platelets; rituximab; thrombocytes