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- Title
Low-dose rituximab in adult patients with primary immune thrombocytopenia.
- Authors
Zaja, Francesco; Vianelli, Nicola; Volpetti, Stefano; Battista, Marta Lisa; Defina, Marzia; Palmieri, Salvatore; Bocchia, Monica; Medeot, Marta; De Luca, Stefano; Ferrara, Felicetto; Isola, Miriam; Baccarani, Michele; Fanin, Renato
- Abstract
Backgrounds: Rituximab 375 mg/m2 weekly for 4 wks has significant activity in adults with primary immune thrombocytopenia (ITP). In this setting, several evidences support the possible use of lower doses of rituximab. Objectives: To investigate the activity of low-dose rituximab as salvage therapy in previously treated symptomatic ITP. Methods: Forty-eight adult patients were treated prospectively with rituximab 100 mg weekly for 4 wks. Results: Overall and complete responses (CR) (platelet level ≥ 50 and 100 × 109/L) were 60.5% and 39.5%, respectively. In responders, the median time to response was 35 d (range: 7-112 d). The median time of observation was 18 months (range 3-49 months). Sixteen of 29 responding patients (55%) relapsed and 14 needed further treatments. The 12- and 24-month cumulative relapse-free survival was 61% and 45%, respectively. In univariate analysis, CR rate was in inverse relation with weight OR = 0.95, CI95% [0.91; 0.99] ( P = 0.019) and age OR=0.96, CI95% [0.93; 0.99] ( P = 0.047). Cox regression model showed that relapse probability increases as weight (HR = 1.06, CI95% [1.0031; 1.111]) and period between diagnosis and rituximab therapy (HR = 1.01, CI95% [1.002; 1.017]) increase. One patient developed an interstitial pneumonia 1 month after the end of rituximab treatment. No other infectious, hematologic or extra-hematologic complications were documented during follow-up. Conclusions: Low-dose rituximab is active in ITP but has moderate long-term effect. A comparative study with standard dose is warranted.
- Subjects
RITUXIMAB; THROMBOCYTOPENIA; MEDICAL research; DRUG efficacy; ANTINEOPLASTIC agents; REGRESSION analysis
- Publication
European Journal of Haematology, 2010, Vol 85, Issue 4, p329
- ISSN
0902-4441
- Publication type
Article
- DOI
10.1111/j.1600-0609.2010.01486.x