ABSTRACT
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Subject(s)
Humans , Pancytopenia/immunology , Immunologic Tests , Autoimmune Diseases/diagnosisABSTRACT
Objetivo: Evaluar el papel del rituximab en el tratamiento de citopenias autoinmunitarias refractarias a tratamientos convencionales. Material y métodos: Estudio descriptivo longitudinal constituido por una serie de casos clínicos (n = 7) durante el período comprendido entre 2003 y 2010. Resultados: Se recogen 7 pacientes: 4, trombocitopenia inmune primaria; 2, anemia hemolítica autoinmunitaria, y 1, neutropenia autoinmunitaria. Un paciente había recibido trasplante de progenitores hematopoyéticos. La dosis fue de 375mg/m2/semana. Cuatro pacientes recibieron 4 dosis y 3 pacientes recibieron 2, 6 y 8 dosis cada uno. Cinco de los pacientes (71%) cumplieron criterios de respuesta global (completa en 4 pacientes y parcial en 1). A las 8,5 semanas, respondieron la mitad de los pacientes (rango: 3,5-19,5). La mediana de la duración de la respuesta fue de 35,5 semanas (rango: 12,5-53,5). El 100% de los respondedores pudo disminuir su tratamiento previo. Se registraron 2 recaídas. No se registran efectos adversos graves. Conclusiones: El 71% de los pacientes de esta serie responden al tratamiento, disminuyendo el 100% de los respondedores su tratamiento previo. Rituximab es un tratamiento bien tolerado, sin efectos secundarios graves en el período de seguimiento estudiado (AU)
Objectives: This study examined the efficacy of rituximab in children with refractory autoimmune cytopenia. Material and methods: Longitudinal descriptive study comprising a series of clinical cases (n=7) during the period 2003 to 2010. Results: A series 7 patients were included (4 had primary immune thrombocytopenia, 2 autoimmune hemolytic anemia, and 1 autoimmune neutropenia). One patient had received stem cell transplantation. Rituximab was administered intravenously to all patients at a dose of 375mg/mg2 weekly. Four patients received 4 doses. Three patients received 2, 6, and 8 doses, respectively. Overall, 5 patients responded (4 complete responses plus 1 partial response). The median time to achieve complete response was 8.5 weeks (range: 3.5-19.5 weeks). Two patients achieved complete response in the first 3.5 weeks, and the remaining 3 patients between 8.5 and 19.5 weeks. The median time of response was 35.5 weeks (range: 12.5-53.5 weeks). Two patients relapsed. No serious adverse events were recorded. Conclusions: Overall, seventy one percent of patients in this study respond to treatment, 100% of responders decrease their previous treatment. Rituximab was a well tolerated and no related serious side effects were recorded during the study period (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Anemia, Hemolytic, Autoimmune/drug therapy , Anemia, Refractory/drug therapy , Antibodies, Monoclonal/therapeutic use , Thrombocytopenia/drug therapy , Patient Safety/statistics & numerical data , Risk Factors , Epidemiology, DescriptiveABSTRACT
OBJECTIVES: This study examined the efficacy of rituximab in children with refractory autoimmune cytopenia. MATERIAL AND METHODS: Longitudinal descriptive study comprising a series of clinical cases (n=7) during the period 2003 to 2010. RESULTS: A series 7 patients were included (4 had primary immune thrombocytopenia, 2 autoimmune hemolytic anemia, and 1 autoimmune neutropenia). One patient had received stem cell transplantation. Rituximab was administered intravenously to all patients at a dose of 375 mg/mg(2) weekly. Four patients received 4 doses. Three patients received 2, 6, and 8 doses, respectively. Overall, 5 patients responded (4 complete responses plus 1 partial response). The median time to achieve complete response was 8.5 weeks (range: 3.5-19.5 weeks). Two patients achieved complete response in the first 3.5 weeks, and the remaining 3 patients between 8.5 and 19.5 weeks. The median time of response was 35.5 weeks (range: 12.5-53.5 weeks). Two patients relapsed. No serious adverse events were recorded. CONCLUSIONS: Overall, seventy one percent of patients in this study respond to treatment, 100% of responders decrease their previous treatment. Rituximab was a well tolerated and no related serious side effects were recorded during the study period.
