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ORIGINAL ARTICLE
Year : 2018  |  Volume : 43  |  Issue : 1  |  Page : 5-9

The use of anti-CD20 in management of Egyptian children with chronic immune thrombocytopenic purpura


Pediatric Hematology, Oncology and Bone Marrow Transplantation Unit, Pediatric Department, Faculty of Medicine, Mansoura University, Egypt

Correspondence Address:
Suzy Abdelmabood
Pediatric Hematology, Oncology & Bone Marrow Transplantation Unit, Pediatric Department, Faculty of Medicine, Mansoura University, Egypt, Mansoura University Children Hospital, 35516, Mansoura
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejh.ejh_44_17

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Background/aim Chronic immune thrombocytopenic purpura (ITP) is an immune-mediated platelet destruction, with decreased platelet count to less than 100×109/l for more than 12 months. Overall, 5–10% of children with chronic ITP experience serious bleeding, and their treatment is challenging. Rituximab is one of treatment options. Our aim is to evaluate low-dose rituximab in the management of childhood chronic ITP. Patients and methods Twenty-eight children with primary chronic ITP were prospectively administered rituximab at a dose of 100 mg/week for 4 weeks and followed up for 1 year. Results The initial response showed that 12/28 (42.8%) achieved complete remission, 2/28 (7%) minimal remission and 14/28 (50%) no remission. No significant differences were detected between responders and nonresponders regarding age and sex (P=0.94 and 0.59, respectively), except that the duration of the disease was significantly longer among nonresponders (P=0.025). The outcome after 1-year follow-up was as follows: one patient lost to follow-up, 14/28 (50%) were nonresponders, 8/28 (28%) relapsed, and 6/28 (21%) maintain sustained remission. Conclusion Rituximab is one of treatment choices for chronic ITP in children with convincing initial results; however, failure to achieve sustained remission is still a problem.


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