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High response rate to low‐dose rituximab plus high‐dose dexamethasone as frontline therapy in adult patients with primary immune thrombocytopenia
Author(s) -
GómezAlmaguer David,
TarínArzaga Luz,
MorenoJaime Brizio,
JaimePérez José Carlos,
CeballosLópez Adrián Alejandro,
RuizArgüelles Guillermo J.,
RuizDelgado Guillermo J.,
CantúRodríguez Olga Graciela,
GutiérrezAguirre Cesar Homero,
SánchezCárdenas Mónica
Publication year - 2013
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12102
Subject(s) - rituximab , dexamethasone , medicine , immune thrombocytopenia , immune system , pediatrics , oncology , immunology , antibody
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.