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Blood, 15 August 2001, Vol. 98, No. 4, pp. 952-957
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Rituximab chimeric anti-CD20 monoclonal antibody treatment for
adults with chronic idiopathic thrombocytopenic purpura
Roberto Stasi,
Adalberto Pagano,
Elisa Stipa, and
Sergio Amadori
From the Department of Medical Sciences, Regina
Apostolorum Hospital, Albano Laziale, Italy; and the Department of
Hematology, University of Rome "Tor Vergata," S. Eugenio Hospital,
Rome, Italy.
The role of rituximab, a chimeric monoclonal antibody
directed against the CD20 antigen, in the treatment of patients with chronic idiopathic thrombocytopenic purpura (ITP) has not been determined. The effectiveness and side effects of this therapeutic modality were investigated in a cohort of 25 individuals with chronic
ITP. All patients had ITP that had been resistant to between 2 and 5 different therapeutic regimens, including 8 patients who had already
failed splenectomy. Patients were scheduled to receive intravenous
rituximab at the dose of 375 mg/m2 once weekly for 4 weeks.
Rituximab infusion-related side effects were observed in 18 patients,
but were of modest intensity and did not require discontinuation of
treatment. A complete response (platelet count greater than
100 × 109/L) was observed in 5 cases, a partial response
(platelet count between 50 and 100 × 109/L) in 5 cases,
and a minor response (platelet count below 50 × 109/L,
with no need for continued treatment) in 3 cases, with an overall
response rate of 52%. In 7 cases, responses were sustained (6 months
or longer). In 2 patients with relapsed disease, repeat challenge with
rituximab induced a new response. In patients with a complete or
partial response, a significant rise in platelet concentrations was
observed early during the course of treatment, usually 1 week after the
first rituximab infusion. No clinical or laboratory parameter was found
to predict treatment outcome, although there was a suggestion that
women and younger patients have a better chance of response. In
conclusion, rituximab therapy has a limited but valuable effect in
patients with chronic ITP. In view of its mild toxicity and the lack of
effective alternative treatments, its use in the setting of chronic
refractory ITP is warranted.

CiteULike Connotea Del.icio.us Digg Reddit Technorati What's this?
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