Darlow Jennifer, Gurumurthy Gerard, Jeffreys Nathan, Reynolds Lianna, Deshani Vismay, Grainger John
Royal Manchester Children's Hospital Manchester UK.
University of Manchester Manchester UK.
EJHaem. 2025 May 1;6(3):e70010. doi: 10.1002/jha2.70010. eCollection 2025 Jun.
Rituximab, a CD20 monoclonal antibody, is used in chronic/refractory immune thrombocytopenia (ITP). Standard dosing is 375 mg/m weekly for 4 weeks alongside dexamethasone. A lower dose of Rituximab at 100 mg weekly demonstrates comparable efficacy that is well tolerated. This study evaluates lower-dose Rituximab with dexamethasone in postpubertal pediatric ITP patients.
Patients treated with 100 mg weekly Rituximab for 4 weeks alongside dexamethasone at 10 mg/m on days 1-5 and 21-25 were assessed for response and safety.
Of the 10 patients treated, six responded completely, one partially and three showed no response. Four responders maintained their response over 2 years. One Rituximab-related infusion reaction and one Dexamethasone-related adverse event were reported.
Rituximab 100 mg weekly may be non-inferior to 375 mg/m weekly for paediatric patients.
利妥昔单抗是一种CD20单克隆抗体，用于治疗慢性/难治性免疫性血小板减少症（ITP）。标准剂量是每周375mg/m²，共4周，同时联合地塞米松使用。每周100mg的较低剂量利妥昔单抗显示出相当的疗效，且耐受性良好。本研究评估了低剂量利妥昔单抗联合地塞米松治疗青春期后儿童ITP患者的效果。
对接受每周100mg利妥昔单抗治疗4周，同时在第1 - 5天和第21 - 25天接受10mg/m²地塞米松治疗的患者进行反应和安全性评估。
在接受治疗的10名患者中，6名完全缓解，1名部分缓解，3名无反应。4名缓解者在2年多的时间里维持了缓解状态。报告了1例与利妥昔单抗相关的输液反应和1例与地塞米松相关的不良事件。
对于儿科患者，每周100mg利妥昔单抗可能不劣于每周375mg/m²。
