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Rituximab therapy in adult patients with relapsed or refractory immune thrombocytopenic purpura: long‐term follow‐up results
Author(s) -
Medeot Marta,
Zaja Francesco,
Vianelli Nicola,
Battista Marta,
Baccarani Michele,
Patriarca Francesca,
Soldano Franca,
Isola Miriam,
De Luca Stefano,
Fanin Renato
Publication year - 2008
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/j.1600-0609.2008.01100.x
Subject(s) - rituximab , medicine , refractory (planetary science) , thrombocytopenic purpura , gastroenterology , toxicity , surgery , platelet , lymphoma , physics , astrobiology
Objective: To evaluate the long‐term activity and toxicity profile of rituximab in adult patients with idiopathic immune thrombocytopenic purpura (ITP). Patients and methods: Twenty‐six patients with active and symptomatic ITP relapsed or refractory received weekly infusions of rituximab 375 mg/m 2 for 4 wk. Median time from diagnosis to rituximab was 34.5 months . The following parameters of efficacy and toxicity were considered: complete response (CR) and partial response (PR), relapse rate, relapse‐free survival (RFS), therapy‐free survival (TFS), short‐ and long‐term toxicity. Results: CR and PR were 14/26 (54%) and 4/26 (15%), respectively. Median time of observation was 56.5 months (range 39–77). Nine of the 18 responding patients relapsed after a median of 21 months (range 8–66); 9/26 patients (35%) maintained the response, with a median follow‐up of 57 months (range 39–69), and 11/26 (42%) did not necessitate further therapy; estimated 5 yr RFS and TFS were 61% and 72%, respectively. Younger age and shorter interval from diagnosis to rituximab appeared indicators of better outcome. Rituximab administration was associated with two episodes of short‐term toxicity, with one case of serum sickness syndrome; no infectious or other significant long‐term complications were documented. Conclusion: Rituximab therapy may achieve long‐lasting remission in nearly one‐third of patients with relapsed or refractory ITP, with a good safety profile.