Hematology Service, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, México.
Eur J Haematol. 2013 Jun;90(6):494-500. doi: 10.1111/ejh.12102. Epub 2013 Apr 2.
Corticosteroids as initial therapy for primary immune thrombocytopenia achieve a low rate of sustained remission.
We prospectively evaluated the efficacy, safety, and response duration of low-dose rituximab plus high-dose dexamethasone as frontline therapy in newly diagnosed primary immune thrombocytopenia patients. One cycle of dexamethasone, 40 mg/d/intravenously for four consecutive days, plus weekly intravenous rituximab, 100 mg for four doses, was delivered.
Twenty-one consecutive adults were enrolled. The overall response at day +28 was 90.5%. Complete sustained response at 6 months and relapse rate were 76.2% and 15.8%, respectively, compared with 30% and 62.5% for a historical group who had received standard treatment with prednisone (P = 0.005 and P = 0.004). There was a 9.5% incidence of adverse effects.
The combination of low-dose rituximab and high-dose dexamethasone as frontline therapy for adults with primary immune thrombocytopenia was effective and had a high overall response rate and a low incidence of relapse.
皮质类固醇作为原发性免疫性血小板减少症的初始治疗方法，缓解持续率较低。
我们前瞻性评估了低剂量利妥昔单抗联合高剂量地塞米松作为新诊断的原发性免疫性血小板减少症患者一线治疗的疗效、安全性和反应持续时间。给予一个周期的地塞米松，40mg/d/静脉内，连续 4 天，加每周静脉内利妥昔单抗，100mg 共 4 剂。
连续纳入 21 例成人。在第 +28 天的总体反应率为 90.5%。与接受泼尼松标准治疗的历史组相比，6 个月时完全持续缓解率和复发率分别为 76.2%和 15.8%（P=0.005 和 P=0.004）。不良反应发生率为 9.5%。
低剂量利妥昔单抗联合高剂量地塞米松作为成人原发性免疫性血小板减少症一线治疗的联合方案有效，总反应率高，复发率低。
