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Clinical Efficacy and Safety of High-Dose Dexamethasone Plus Low-Dose Rituximab as First-Line Therapy in Newly Diagnosed Primary Immune Thrombocytopenia

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Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

Standard-dose prednisone as first-line therapy for primary immune thrombocytopenia (ITP) can not obtain high long-term responses. Results from high-dose dexamethasone course administered in adult newly diagnosed ITP were promising. The role of standard-dose rituximab in first-line treatment of newly diagnosed ITP were also investigated. We retrospectively analyzed the efficacy and safety of high-dose dexamethasone plus low-dose (100 mg/w) rituximab for treatment of adults newly diagnosed ITP. A total of eighteen patients received dexamethasone 40 mg/day for 4 consecutive days (days + 1 to +  4), rituximab 100 mg once weekly for a total of 4 weeks (days + 7, + 14, + 21 and + 28). Non-responders accepted the repeated dexamethasone treatment every 2 weeks for a total of up to 3 treatment cycles. The overall response was 100% at 28th day. Median follow-up was 17 months (1–33 months). Six patients (33.3%) relapsed. Sustained complete response or response after 6 months and 12 months of follow-up were reached in 83.3% (15/18) and 61.5% (8/13) of patients respectively. The 12-month and 15-month cumulative relapse-free survival were 69.3% and 60.7%. Incidence of adverse effects was 11.1% (2/18). High-dose dexamethasone plus low-dose rituximab therapy had high efficacy and well tolerability as first-line treatment option in newly diagnosed ITP.

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Acknowledgements

This work was supported in part by Grants of National Natural Science Foundation of China (81370615), the Education Department of Henan Province (14B320024).

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  1. Hu Zhou and Liu Liu have contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, Affiliated Tumor Hospital of Zhengzhou University, Tumor Hospital of Henan Province, Institute of Hematology of Henan Province, 127 Dongming Road, Zhengzhou, 450000, People’s Republic of China

    Hu Zhou, Xinhui Shu, Xiaoran Wang & Yongping Song

  2. Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China

    Liu Liu

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  1. Hu Zhou
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  2. Liu Liu
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  3. Xinhui Shu
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  4. Xiaoran Wang
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  5. Yongping Song
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Correspondence to Yongping Song.

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Zhou, H., Liu, L., Shu, X. et al. Clinical Efficacy and Safety of High-Dose Dexamethasone Plus Low-Dose Rituximab as First-Line Therapy in Newly Diagnosed Primary Immune Thrombocytopenia. Indian J Hematol Blood Transfus 35, 507–512 (2019). https://doi.org/10.1007/s12288-018-1061-7

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