Safety And Efficacy Analysis Of Two Lower Dosage Regimens Of Rituximab In Adult Immune Thrombocytopenia

Objective To investigate the safety and efficacy of two lower dosage regimens of rituximab in adult immune thrombocytopenia(ITP),and to analyze the influencing factors of treatment effect.Methods A total of 61 patients with ITP, were allocated randomly to two lower dosage regimens of rituximab (group A:rituximab 100 mg weekly for 4 weeks,27 patients;group B:rituximab 375 mg/m2 only once,34 patients). The Overall response(OR) rate and complete response(CR) rate of two lower dosage regimens of rituximab were analyzed, and the safety and efficacy of two lower dosage regimens of rituximab in adult immune thrombocytopenia were investigated.Finally, the influencing factors of treatment effect were analyzed.The statistics was performed by software SPSS 20.0.Results Among 61 ITP patients,25 male and 36 female, the median age were 33(18-60) years old and the median course of disease were 14(1-29)months. The overall response (OR) rate and the complete response (CR) rate was respectively 61.7% and 46.7% at 6 months after rituximab treatment within 60 patients follow-up. The OR vs CR rate was 64.1% vs 46.2% at 12 months after treatment within 39 patients follow-up. The OR vs CR rate was 50.8% vs 31.1% at the end of follow-up.The continuous OR/CR duration were respectively 15(6-29)/12(5-28) months. There was no significant difference between OR and CR rate in the two groups. And there was also no significant difference between the continuous OR and CR duration.Skin urticaria occurred in 2 cases of patients during infusion. One patient had symptom of chest tightness and one patient had fever. Six patients had pneumonia,5 patients get better after treatment, and one patient progressed to severe pneumonia and was transferred to ICU of another hospital for further treatment.Platelet anti-GPⅡb/Ⅲa autoantibody could be the influencing factor of rituximab treatment effect.Conclusions Lower dosage regimen of rituximab is an effective treatment for adult immune thrombocytopenia, adverse reactions can be tolerated.There was no significant difference between two kinds of lower dosage regimens of rituximab in adult immune thrombocytopenia. Platelet anti-GPⅡb/Ⅲa autoantibody could be the influencing factor of rituximab treatment effect.