Safe and Efficacious Use of Low-Dose Rituximab in Postpubertal Paediatric Patients With Immune Thrombocytopenia

EJHaem Pub Date : 2025-05-01 DOI:10.1002/jha2.70010

Jennifer Darlow, Gerard Gurumurthy, Nathan Jeffreys, Lianna Reynolds, Vismay Deshani, John Grainger

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Abstract

Background

Rituximab, a CD20 monoclonal antibody, is used in chronic/refractory immune thrombocytopenia (ITP). Standard dosing is 375 mg/m² 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.

Methods

Patients treated with 100 mg weekly Rituximab for 4 weeks alongside dexamethasone at 10 mg/m² on days 1–5 and 21–25 were assessed for response and safety.

Results

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.

Conclusion

Rituximab 100 mg weekly may be non-inferior to 375 mg/m² weekly for paediatric patients.

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低剂量利妥昔单抗在青春期后儿童免疫性血小板减少症患者中的安全有效应用

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）。标准剂量为每周375 mg/m2，与地塞米松一起服用4周。较低剂量的利妥昔单抗每周100毫克显示出相当的疗效，耐受性良好。本研究评估了低剂量利妥昔单抗与地塞米松在青春期后儿童ITP患者中的作用。方法采用利妥昔单抗100 mg/周治疗4周，同时采用地塞米松剂量10 mg/m2治疗1 ~ 5天、21 ~ 25天，观察疗效和安全性。结果10例患者中，完全缓解6例，部分缓解1例，无缓解3例。4名应答者在2年多的时间里保持了他们的反应。报告1例利妥昔单抗相关输液反应和1例地塞米松相关不良事件。结论利妥昔单抗100 mg/周的治疗效果优于375 mg/周。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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EJHaem

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