Evolución clínica de 31 pacientes adultos con trombocitopenia inmune tratados con rituximab

BACKGROUND: Primary immune thrombocytopenia (ITP) is an autoimmune disease that could cause different grades of bleeding, which could even threat the patients’ life or make them experience poor quality of life. ITP can be treated with rituximab either as a first or second-line therapy option, resulting in an overall response of 60%. The best results have been observed on young women with a short time of disease evolution. OBJECTIVE: To report the response and clinical evolution by providing therapy with rituximab, which was used as a rescue in adult patients with either persistent or chronical ITP. MATERIAL AND METHODS: 4 weekly doses of rituximab were administered to 31 adult patients and it was made a follow-up with them for a year. RESULTS: Out of the 31 patients, a complete response was observed (CR, platelets ≥ 100 x 109 /L) in 22 patients (71%), and a partial response (PR, platelets ≥ 30 and ≤ 99 x 109 /L) in 5 patients (16%); the global response was of 87%. 3 patients relapsed during follow-up and sustained response after rituximab (≥ 12 months) was held in 24 patients, 21 (67%) with CR and 3 (10%) with PR. Side effects were from low to moderate in 13% of patients. CONCLUSIONS: Rituximab showed its effectiveness in patients with ITP as a rescue therapy in both chronical and persistent phases. Sustained response ≥ 12 months was of 77%, with good tolerance and acceptable toxicity.