This retrospective study investigated the effects of rituximab in 19 pediatricpatients (15 girls and 4 boys) with chronic refractory symptomatic immunethrombocytopenic purpura (ITP). Patients received from 2 to 5 weekly infusions ofrituximab (375 mg/m(2)); 15 patients were younger than 12 years when treated. Themedian follow-up time was 30 months (range, 9-43 months). The overall responserate was 68% (13/19 patients). Six responders relapsed at a median of 4.5 months (range, 3-8 months). Seven patients still displayed a platelet count>150,000/microL at a median of 33 months (range, 14-43 months) after rituximabtreatment. Six of 15 patients treated with 4 or 5 weekly infusions and 1 of 4patients treated with 2 or 3 infusions are still in remission. No difference was detected between splenectomized and nonsplenectomized patients. The duration ofITP disease at the time of treatment did not influence the response rate.Patients still in remission showed significantly lower levels of CD19+ cellsafter 4 and 6 months than nonresponding or relapsed patients (P < .05). No major infections were reported during follow-up. Our data show the efficacy andtolerability of rituximab in young children with refractory symptomatic ITP.Nonrelapsed patients showed a more prolonged B-cell depletion.
Rituximab (anti-CD20 monoclonal antibody) in children with chronic refractory symptomatic immune thrombocytopenic purpura: Efficacy and safety of treatment
CESARO, SIMONE;
2006-01-01
Abstract
This retrospective study investigated the effects of rituximab in 19 pediatricpatients (15 girls and 4 boys) with chronic refractory symptomatic immunethrombocytopenic purpura (ITP). Patients received from 2 to 5 weekly infusions ofrituximab (375 mg/m(2)); 15 patients were younger than 12 years when treated. Themedian follow-up time was 30 months (range, 9-43 months). The overall responserate was 68% (13/19 patients). Six responders relapsed at a median of 4.5 months (range, 3-8 months). Seven patients still displayed a platelet count>150,000/microL at a median of 33 months (range, 14-43 months) after rituximabtreatment. Six of 15 patients treated with 4 or 5 weekly infusions and 1 of 4patients treated with 2 or 3 infusions are still in remission. No difference was detected between splenectomized and nonsplenectomized patients. The duration ofITP disease at the time of treatment did not influence the response rate.Patients still in remission showed significantly lower levels of CD19+ cellsafter 4 and 6 months than nonresponding or relapsed patients (P < .05). No major infections were reported during follow-up. Our data show the efficacy andtolerability of rituximab in young children with refractory symptomatic ITP.Nonrelapsed patients showed a more prolonged B-cell depletion.
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