Rituximab Is Highly Effective In The Treatment Of Patients With Autoimmune Blood Cytopenias, Particularly When It Is Followed By a Post-Induction Consolidation / Maintenance Phase

• Published in: Blood 2013-11, Vol.122 (21), p.3539-3539
• Main Authors: Symeonidis, Argiris, Giannakoulas, Nikolaos, Kapsali, Eleni, Christoforidou, Anna, Topouzoglou, Zoe, Lampropoulou, Polyxeni, Tzouvara, Evangelia, Anagnostopoulos, Nikolaos, Margaritis, Dimitris, Vassilopoulos, George, Briasoulis, Evangelos, Kouraklis, Alexandra
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V122.21.3539.3539

Rituximab is a chimeric anti-CD20 monoclonal antibody, which targets both, autoreactive and neoplastic B-lymphocytes, thus representing a rational therapeutic approach for patients with various autoimmune disorders. However, although rituximab has been used asa treatment option for patients with autoimmune blood cytopenias, its optimal use has not yet been established. In an effort to analyze the effectiveness and safety of rituximab treatment in this patient population, we have retrospectively analyzed treatment outcome of 147 patients with various autoimmune blood cytopenias or related disorders (AutoImmuneHemolytic Anemia-AIHA N=31, Immune Thrombocytopenic Purpura-ITP N=67, Thrombotic Thrombocytopenic Purpura-TTP N=32, Evans'Syndrome-ES N=10, Acquired Hemophilia-AH N=4, Anti-Phospholipid Syndrome-APS N=2 and Immune Neutropenia-IN N=1). Eligible patients should have received at least 3 courses of rituximab treatment, unless would have been died earlier due to treatment-related causes. Patients were 68 male and 79 female, with a median age of 52 years (range 15-87 years) and were treated following 1-7 (median 2) lines of previous treatment, for an early (12 months, N=39) or for refractory disease (N=48), at a median of 3.4 months following initial diagnosis (range 0.1-430 months). Eighteen patients received rituximab as first-line treatment due to contra-indication (N=10) or intolerance (N=8) of corticosteroids. Rituximab was administered at the classical dose of 375 mg/m2 (N=113) or at a reduced dose of 200 mg/m2 (N=26), whereas 8 patients initially received 375 mg/m2 for 1-6 cycles and continued with the reduced dose. Each patient received a median of 6 courses of rituximab (range 1-60 courses). Four out of 143 patients were HBsAg positive, and 62/133 were anti-HBc positive. These patients received lamivudineprophylaxis,throughout rituximab treatment and up to 6 months following rituximab withdrawal. Seven patients (4.8%) received