TWO YEARS EFFECTIVENESS OF RITUXIMAB IN REFRACTORY IDIOPATHIC THROM-BOCYTOPENIC PURPURA

Abstract

Background and aim: The treatment of immune thrombocytopenia (ITP) started with steroids but most patients will relapse or have significant adverse effects. The use of Rituximab was greeted enthusiastically: it led to up to 60% response rates, making it the main alternative to splenectomy, with far fewer side effects. The aim of study to assess the 2 years effectiveness of rituximab in the managements of patients with chronic and refractory immune thrombocytopenic purpura (ITP).

Methods and Materials: Retrospective study included 22 patients labeled as refractory chronic idiopathic thrombocytopenic purpura (ITP), This study was conducted at King Hussein Medical center / Amman -Jordan, Hematology and Oncology Department between February 2017 and February 2019, a weekly 4 doses of Rituximab 375mg/m2 were given, a 2 years regular follow up on the efficacy and safety of rituximab were identified.

Results: The mean age at diagnosis was 36.7 years (19-54), Mean platelet count before rituximab treatment was 8×109 /L.All patients were followed for 2 years , the overall response rate to rituximab was 59.1 % at 6 months (CR 31.8 %, PR 27.2 %) ,The median time to response was 4 weeks (1-8 wks.) ,with 45.5 %of all patient responded within 1 month, 22.8% lost response at 1 year (accumulative 1 year response 36.3%) , further 9.1% lost response at 2 years (accumulative 2 year response 27.2 %) , 13.6% did not showed any response.

Conclusion: over 2 year’s observation, our study confirms effectiveness and safety of rituximab in management of chronic refractory ITP.