Treatment Results of Children with Chronic Immune Thrombocytopenic Purpura (ITP) Treated with Rituximab

Çıtak, Elvan Çağlar; Citak, Funda Erkasar

doi:10.1093/tropej/fmq033

Cited by 8 publications

(15 citation statements)

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“…Characteristics of these patients were described in table 2. 171 (48.6%) patients in 6 studies [17], [18], [20], [22], [24], [28] were from USA/Canada, and 181 (51.4%) patients were from other countries, including Germany [16], Italy [23], France [19] Czech Republic [31],Portugal [32], China [26], [27], [33], Turkey [21], [25], South Korea [30] and India [29]. 304 patients were diagnosed as primary ITP, and 48 cases were diagnosed as secondary ITP associated with other diseases, including Evans syndrome, systemic lupus erythematosus, and autoimmune lymphoproliferative syndrome.…”

Section: Resultsmentioning

confidence: 99%

“…We calculated the pooled response rate according to criteria defined in this systematic review. Response (platelet count ≥30×10 9 /L) after rituximab treatment was reported in 14 studies [16]–[18], [20], [21], [23], [25]–[29], [31]–[33] involving 312 patients, and was achieved in 201 patients (64.4%). 19 (6%) patients, although diagnosed as secondary ITP, were still included in the analysis as their data can not be separated.…”

Section: Resultsmentioning

confidence: 99%

“…The heterogeneity between studies was statistically significant (P<0.001) (Figure 2). Complete response was reported in 14 studies [16]–[18], [20], [21], [23], [25]–[27], [29]–[33] involving 243 patients, and was achieved in 99 patients (40.7%). The reported complete response rate ranged from 14% [33] to 67% [26], and the pooled rate was 39% (95%CI, 30% to 49%).…”

Section: Resultsmentioning

confidence: 99%

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Rituximab for Children with Immune Thrombocytopenia: A Systematic Review

et al. 2012

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BackgroundRituximab has been widely used off-label as a second line treatment for children with immune thrombocytopenia (ITP). However, its role in the management of pediatric ITP requires clarification. To understand and interpret the available evidence, we conducted a systematic review to assess the efficacy and safety of rituximab for children with ITP.Methodology/Principal FindingsWe searched MEDLINE, EMBASE, Cochrane Library, CBM, CNKI, abstract databases of American Society of Hematology, American Society of Clinical Oncology and Pediatric Academic Society. Clinical studies published in full text or abstract only in any language that met predefined inclusion criteria were eligible. Efficacy analysis was restricted to studies enrolling 5 or more patients. Safety was evaluated from all studies that reported data of toxicity. 14 studies (323 patients) were included for efficacy assessment in children with primary ITP. The pooled complete response (platelet count ≥100×109/L) and response (platelet count ≥30×109/L) rate after rituximab treatment were 39% (95% CI, 30% to 49%) and 68% (95%CI, 58% to 77%), respectively, with median response duration of 12.8 month. 4 studies (29 patients) were included for efficacy assessment in children with secondary ITP. 11 (64.7%) of 17 patients associated with Evans syndrome achieved response. All 6 patients with systemic lupus erythematosus associated ITP and all 6 patients with autoimmune lymphoproliferative syndrome associated ITP achieved response. 91 patients experienced 108 adverse events associated with rituximab, among that, 91 (84.3%) were mild to moderate, and no death was reported.Conclusions/SignificanceRandomized controlled studies on effect of rituximab for children with ITP are urgently needed, although a series of uncontrolled studies found that rituximab resulted in a good platelet count response both in children with primary and children secondary ITP. Most adverse events associated with rituximab were mild to moderate, and no death was reported.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Rituximab for Children with Immune Thrombocytopenia: A Systematic Review

et al. 2012

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“…La eficacia de rituximab en citopenias autoinmunitarias ha sido descrita en adultos, sobre todo en PTI 6 y AHAI 7 . Sin embargo, los datos en pacientes pediátricos son escasos [8][9][10][11][12][13][14][15][16][17][18] . En la interpretación de estudios previos destaca la heterogeneidad de los criterios de respuesta al tratamiento (tabla 3).…”

Section: Discussionunclassified

Rituximab en el tratamiento de citopenias autoinmunitarias refractarias a tratamientos convencionales

Frías

Sánchez

Valentin

et al. 2013

Anales de Pediatría

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“…Csak külön egyedi engedéllyel, "offlabel" alkalmazható! A nemzetközi adatok alapján a terá-piás válasz 30-65% [21,22]. Mellékhatásként súlyos szepszist és elhúzódó hypogammaglobulinaemiát (négy-hat hónap) okozhat.…”

Section: Rituximabunclassified

Újdonságok a gyermekkori immunthrombocytopenia kezelésében – 2017

Kovács

Kiss

2017

Orvosi Hetilap

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A gyermekkori immunthrombocytopenia (ITP) nagyon változatos kórkép. A különböző nemzetközi ajánlások nem szabnak meg szigorú előírásokat, csupán terápiás lehetőségekről beszélnek. A hazai gyakorlat alapján 2011-ben egy konkrét terápiás algoritmus került bemutatásra. Az elmúlt években új innovatív szerek állnak rendelkezésre már Magyarországon is, ezért időszerű a terápiás ajánlások átgondolása és újrafogalmazása. A jelen munkában napjaink korszerű ellátási elveit mutatjuk be. Csecsemő-és gyermekkorban továbbra is elsősorban a nagy adagú intravénás immunglobulin-kezelést javasoljuk, idősebb életkorban és alternatívaként a szteroidkezelés is indikált (lökéskezelés vagy elnyújtott kis adagú kezelés formájában). Rezisztens esetekben az új, innovatív trombopoetinreceptor-izgató szerek közül ma már gyermekeknek is törzskönyvezett készítmény az eltrombopág, amely nagyon hatékonyan javítja a kór-lefolyást. A lépkivétel gyermekkorban csak kivételes esetben jön szóba. Az ITP kiszámíthatatlan kórkép, és bár gyermekkorban mintegy 70-80%-ban gyógyul, szakorvosi ellátást és hosszú távú követést igényel. Orv Hetil. 2017; 158(48): 1891-1896. Kulcsszavak: gyermekkori ITP, vérzés, terápiás ajánlás, immunglobulin, trombopoetinreceptor Novelties in the treatment of pediatric immune thrombocytopenia -2017Immune thrombocitopenia in children is a very variable disease. International recommendations give therapeutic possibilities without strong protocols. In 2011, a therapeutic algorithm was published based on Hungarian practice. Recently, new innovative drugs have been available even in Hungary, so there is a need for modification of the therapeutic protocols. In this summary we give an overview about the current up-to-date management. In infancy and in childhood, high-dose immunglobulin treatment is recommended henceforward. In older children an alternative can be steroid therapy (pulses or long-term low-dose treatment). In resistant cases, a new thrombopoetin receptor stimulant, eltrombopag can be administered. This drug is registered in Hungary, and can very effectively influence the prognosis. Splenectomy is very rare nowadays in children. Immune thrombocytopenia is an unpredictable disease. Cure rate is about 70-80% of the cases, but management of the patients needs special care and specialist.

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Treatment Results of Children with Chronic Immune Thrombocytopenic Purpura (ITP) Treated with Rituximab

Cited by 8 publications

References 5 publications

Rituximab for Children with Immune Thrombocytopenia: A Systematic Review

Rituximab for Children with Immune Thrombocytopenia: A Systematic Review

Rituximab en el tratamiento de citopenias autoinmunitarias refractarias a tratamientos convencionales

Újdonságok a gyermekkori immunthrombocytopenia kezelésében – 2017

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