Prevzaté: Rituximab therapy in adult patients with relapsed or refractory ITP|
Posted on 30.10.2009 16:41
Rituximab therapy in adult patients with relapsed or refractory immune thrombocytopenic purpura: long-term follow-up results
Marta Medeot1, Francesco Zaja1, Nicola Vianelli2, Marta Battista1, Michele Baccarani2, Francesca Patriarca1, Franca Soldano3, Miriam Isola3, Stefano De Luca1, Renato Fanin1
1Clinica Ematologica, DIRM, University of Udine, Udine, Italy; 2Istituto di Ematologia ed Oncologia Medica L. e A. Seragnoli, Bologna, Italy; 3Istituto di Statistica, DIRM, University of Udine, Udine, Italy
European Journal of Haematology 2008 81 (165–169)
Correspondence Francesco Zaja, MD, Clinica Ematologica, University of Udine, P.zza S. Maria della Misericordia, 33100 Udine, Italy.
Tel: +39 432 559604; Fax: +39 432 559661; e-mail: email@example.com
Objective: To evaluate the long-term activity and toxicity profile of rituximab in adult patients with idiopathic immune thrombocytopenic purpura (ITP). Patients and methods: Twenty-six patients with active and symptomatic ITP relapsed or refractory received weekly infusions of rituximab 375 mg⁄m2 for 4 wk. Median time from diagnosis to rituximab was 34.5 months. The following parameters of efficacy and toxicity were considered: complete response (CR) and partial response (PR), relapse rate, relapse-free survival (RFS), therapy - free survival (TFS), short- and long-term toxicity.
Results: CR and PR were 14 ⁄ 26 (54%) and 4 ⁄ 26 (15%), respectively. Median time of observation was 56.5 months (range 39–77). Nine of the 18 responding patients relapsed after a median of 21 months (range 8–66); 9 ⁄ 26 patients (35%) maintained the response, with a median follow-up of 57 months (range 39–69), and 11 ⁄ 26 (42%) did not necessitate further therapy; estimated 5 yr RFS and TFS were 61% and 72%, respectively. Younger age and shorter interval from diagnosis to rituximab appeared indicators of better outcome. Rituximab administration was associated with two episodes of short-term toxicity, with one case of serum sickness syndrome; no infectious or other significant long-term complications were documented.
Conclusion: Rituximab therapy may achieve long-lasting remission in nearly one-third of patients with relapsed or refractory ITP, with a good safety profile.
Key words immune thrombocytopenic purpura; rituximab; long-term activity
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