International Journal of Hematology

, Volume 92, Issue 2, pp 283–288

Rituximab in immune thrombocytopenia: transient responses, low rate of sustained remissions and poor response to further therapy in refractory patients

  • Aamer Aleem
  • Ahmed S. Alaskar
  • Farja Algahtani
  • Mushtaq Rather
  • Muhamad Hitham Almahayni
  • Abdulkarim Al-Momen
Original Article

DOI: 10.1007/s12185-010-0635-4

Cite this article as:
Aleem, A., Alaskar, A.S., Algahtani, F. et al. Int J Hematol (2010) 92: 283. doi:10.1007/s12185-010-0635-4

Abstract

Management of patients with immune thrombocytopenia (ITP) refractory to standard treatment is difficult. Recent studies show that rituximab, a chimeric anti-CD20 monoclonal antibody, is useful in the treatment of ITP. We retrospectively studied 24 patients who received 29 rituximab treatments for relapsed or refractory ITP. Patients had received a median of 3 treatment regimens before (range 1–8) and 11 patients had prior splenectomy. Responses were achieved in 19 of 29 (66%) treatments. The median time to response was 3 weeks (range 1–20) from the start of therapy and median duration of response was 13 weeks (range 1 week–55 months). Responses were mostly short lived and after a median follow-up of 22 months (range 2–70), 10 (34%) responses were sustained after 6 months, 7 (24%) responses sustained after 1 year and only 5 patients continued to have a response at last visit after 8, 10, 24, 30 and 54 months of follow-up. Previous splenectomy was associated with a poor response (p = 0.034). Patients who failed rituximab and had prior multiple treatments including splenectomy, had a poor outcome of further therapies. We conclude that rituximab is well tolerated and is useful in some patients with relapsed or refractory ITP; however, only about one-fifth of patients achieved sustained remissions. Patients refractory to rituximab had a poor response to further treatment.

Keywords

Immune thrombocytopeniaITPAdultsPlateletsRituximab

Copyright information

© The Japanese Society of Hematology 2010

Authors and Affiliations

  • Aamer Aleem
    • 1
  • Ahmed S. Alaskar
    • 2
  • Farja Algahtani
    • 1
  • Mushtaq Rather
    • 2
  • Muhamad Hitham Almahayni
    • 1
  • Abdulkarim Al-Momen
    • 1
  1. 1.The Division of Haematology/Oncology, Department of Medicine (38), College of Medicine and King Khalid University HospitalKing Saud UniversityRiyadhSaudi Arabia
  2. 2.The Division of Adult Haematology, Department of OncologyKing Abdulaziz Medical CityRiyadhSaudi Arabia