Clinical remission following monoclonal anti‐CD20 therapy in two children with chronic refractory idiopathic thrombocytopenic purpura

• Published in: Journal of paediatrics and child health 2005-07, Vol.41 (7), p.384-386
• Main Authors: Moschovi, Maria, Trimis, Georgios, Pergantou, Helini, Platokouki, Heleni, Vrachnou, Eleni, Tzortzatou‐Stathopoulou, Fotini
• Format: Article
• Language: English
• Subjects: Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal - immunology; Antibodies, Monoclonal - therapeutic use; Antigens, CD20 - immunology; anti‐CD20 antibody; autoimmune diseases; B cells; Case studies; Child; Child, Preschool; Children & youth; chronic refractory immune thrombocytopenic purpura; Dermatitis; Drug therapy; Female; Humans; Immunoglobulins; Male; Purpura, Thrombocytopenic, Idiopathic - drug therapy; Remission Induction
• ISSN: 1034-4810; 1440-1754
• DOI: 10.1111/j.1440-1754.2005.00641.x

:  Two patients, a 4‐year‐old boy and a 6‐year‐old girl who had a 2‐year and a 3‐year history of idiopathic thrombocytopenic purpura, respectively, were referred to our Department. Both patients had frequent haemorrhagic events. They received i.v. immunoglobulin, corticosteroids, cyclosporine, interferon α‐2b and azathioprine, but no clinical remission was established. The girl also underwent splenectomy. Anti‐CD20 antibody was administered to both patients at a dose of 375 mg/m2 once weekly for 4 weeks. No side‐effects were detected. During the 18‐month follow‐up period the patients received no other drug and remained in clinical remission. The B lymphocytes remained undetectable in peripheral blood for 3 months and they progressively increased during the following 4 months. Rituximab is a novel, quite effective, safe treatment of chronic refractory idiopathic thrombocytopenic purpura in childhood. More studies and follow up of patients for longer periods are necessary.