TY - JOUR
T1 - Rituximab in immune thrombocytopenia
T2 - gender, age, and response as predictors of long-term response
AU - Marangon, Miriam
AU - Vianelli, Nicola
AU - Palandri, Francesca
AU - Mazzucconi, Maria Gabriella
AU - Santoro, Cristina
AU - Barcellini, Wilma
AU - Fattizzo, Bruno
AU - Volpetti, Stefano
AU - Lucchini, Elisa
AU - Polverelli, Nicola
AU - Carpenedo, Monica
AU - Isola, Miriam
AU - Fanin, Renato
AU - Zaja, Francesco
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Objectives: To evaluate the efficacy of a salvage treatment with rituximab (RTX) in adults with primary immune thrombocytopenia (ITP), in terms of short-term response and long-term response (LTR, i.e., probability to achieve and maintain response) and to identify biological and clinical predictors of response. Methods: We retrospectively evaluated the outcome of patients with primary ITP treated with standard dosage RTX (375 mg/m2 × 4) as salvage therapy in five Italian centers. One hundred and three patients, median age of 46 yr, were included. The median period of observation was 59 months. Results: Response (R) and complete response (CR) were documented in 57 (55%) and 37 (36%) patients, respectively. Patients younger than 40 yr had a higher probability to achieve CR (P = 0.025). Younger women (age < 40 yr) had a significantly higher probability to achieve R and CR (P = 0.039 and P = 0.009, respectively). The estimated LTR rate was 36% and 31% after 48 and 72 months, respectively; female sex (P = 0.033) and younger age (P = 0.021) were associated with better LTR. Younger women had the highest LTR rate (P = 0.006). Response duration was associated with the obtainment of CR after RTX (CR vs. partial response, P = 0.002). Conclusions: The effect of RTX salvage treatment appears higher in younger women, with LTR rate possibly approaching that of splenectomy.
AB - Objectives: To evaluate the efficacy of a salvage treatment with rituximab (RTX) in adults with primary immune thrombocytopenia (ITP), in terms of short-term response and long-term response (LTR, i.e., probability to achieve and maintain response) and to identify biological and clinical predictors of response. Methods: We retrospectively evaluated the outcome of patients with primary ITP treated with standard dosage RTX (375 mg/m2 × 4) as salvage therapy in five Italian centers. One hundred and three patients, median age of 46 yr, were included. The median period of observation was 59 months. Results: Response (R) and complete response (CR) were documented in 57 (55%) and 37 (36%) patients, respectively. Patients younger than 40 yr had a higher probability to achieve CR (P = 0.025). Younger women (age < 40 yr) had a significantly higher probability to achieve R and CR (P = 0.039 and P = 0.009, respectively). The estimated LTR rate was 36% and 31% after 48 and 72 months, respectively; female sex (P = 0.033) and younger age (P = 0.021) were associated with better LTR. Younger women had the highest LTR rate (P = 0.006). Response duration was associated with the obtainment of CR after RTX (CR vs. partial response, P = 0.002). Conclusions: The effect of RTX salvage treatment appears higher in younger women, with LTR rate possibly approaching that of splenectomy.
KW - hemostaseology and platelets
KW - rituximab
KW - thrombocytes
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U2 - 10.1111/ejh.12839
DO - 10.1111/ejh.12839
M3 - Article
C2 - 27981682
AN - SCOPUS:85010441780
SN - 0902-4441
VL - 98
SP - 371
EP - 377
JO - European Journal of Haematology
JF - European Journal of Haematology
IS - 4
ER -