Use of rituximab in immune thrombocytopenia at the University Hospital
Experiencia en el Hospital de Clínicas
Abstract
Introduction: rituximab is a monoclonal antibody that specifically binds to the B-lymphocyte antigen CD20. Use of rituximab in the treatment of refractory immune thrombocytopenia (ITP) is not approved in its technical specifications.
Objective: to describe the clinical characteristics, response to treatment and safety in connection with the use of rituximab in patients with refractory immune thrombocytopenia who are treated at the Hematology Service of the University Hospital, and to review the evidence on the clinical benefits expected for this group of patients.
Method: a descriptive study of patients with refractory immune thrombocytopenia who were seen at the Hematology Service of the University Hospital and who were treated with rituximab was conducted. A bibliographic search on the use of rituximab in this disease was done using PubMed.
Results: four patients with refractory immune thrombocytopenia were treated with rituximab. Three patients responded to treatment. Average time of response was 9.25 weeks. Response has been sustained in the three patients. No side effects were evidenced during the perfusion of rituximab. Evidence published is limited to observational studies in adults, with a few patients, and favorable results have been obtained.
Conclusions: there are limitations in the evidence about treatment of refractory immune thrombocytopenia, although rituximab constitutes an effective alternative. The integration of clinicians is essential in order to monitor the effectiveness and safety of the use of monoclonal antibodies, especially when indications lack approval.
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