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Rituximab in immune thrombocytopenia: gender, age, and response as predictors of long‐term response
Author(s) -
Marangon Miriam,
Vianelli Nicola,
Palandri Francesca,
Mazzucconi Maria Gabriella,
Santoro Cristina,
Barcellini Wilma,
Fattizzo Bruno,
Volpetti Stefano,
Lucchini Elisa,
Polverelli Nicola,
Carpenedo Monica,
Isola Miriam,
Fanin Renato,
Zaja Francesco
Publication year - 2017
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.12839
Subject(s) - medicine , rituximab , immune thrombocytopenia , complete response , immune system , splenectomy , salvage therapy , gastroenterology , surgery , immunology , chemotherapy , platelet , lymphoma , spleen
Objectives 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/m 2 × 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.