Low-dose rituximab combined with dexamethasone in the treatment of refractory ITP in children: Clinical analysis of 31 cases

Gaoyuan Sun; Xin Tian; Chunlian Fang; Jiaxin Gan; Yuhong WU; Xiaoyan Mao; Runxiu Yin; Yiling Guo; Jingjing Qin

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Low-dose rituximab combined with dexamethasone in the treatment of refractory ITP in children: Clinical analysis of 31 cases

VernacularTitle:31例小剂量利妥昔单抗联合地塞米松治疗儿童难治性ITP的临床分析
Author: Gaoyuan SUN ^{1
,

2} ; Xin TIAN ¹ ; Chunlian FANG ¹ ; Jiaxin GAN ³ ; Yuhong WU ⁴ ; Xiaoyan MAO ⁴ ; Runxiu YIN ⁴ ; Yiling GUO ³ ; Jingjing QIN ³
Author Information

1. Kunming Children′s Hospital, Kunming 650100, China
2. School of Clinical Medicine, Dali University
3. School of Clinical Medicine, Dali University
4. Kunming Medical University
Publication Type:Journal Article
Keywords: children; immune thrombocytopenia; rituximab; dexamethasone
From: Chinese Journal of Blood Transfusion 2021;34(6):616-619
CountryChina
Language:Chinese
Abstract: 【Objective】 To investigate the clinical efficacy and safety of low-dose rituximab combined with dexamethasone in the treatment of refractory ITP (RITP) in children. 【Methods】 A total of 31 RITP children, admitted to the Hematology Department of Kunming Children′s Hospital from January 2016 to December 2019 and agreed to receive low-dose rituximab (100 mg/ time, once a week, for 4 successive weeks) combined with dexamethasone (0.6 mg/kg, once a day, for 4 successive days) were enrolled and studied. Blood routine was monitored every other day during treatment, and adverse drug reactions were recorded. The influence of gender, disease course and age on prognosis was compared by χ² test. 【Results】 1) Among the 31 cases, 11 (35.5%) had platelets >100×10⁹/L after 4 weeks and had no recurrence in 6 months; 9 (29%) had platelets >30×10⁹/L but <100×10⁹/L and had no recurrence in 6 months; 11 (35.5%) showed no recovery of platelets, which were consistently lower than 30×10⁹/L. 2) Rituximab was used in 4 cases (12.9%), 1 case (3.2%) presented with severe drug-induced rashes; Headache, vomiting and elevated blood pressure occurred in 2 cases (6.4%). 1 case (3.2%) presented with laryngeal edema. 3) There was no difference in the total effective rate among different gender, age and disease course (P >0.05). 【Conclusion】 The total effective rate of low-dose rituximab combined with dexamethasone for children with refractory ITP in 6 months is 64.5%, and the adverse reactions are tolerable, so it can be used as a treatment option for children with refractory ITP.