Female adolescent patients with a diagnosis of chronic idiopathic thrombocytopenic purpura (ITP) made less than 2 years prior may experience durable, unmaintained remission once treated with 4 infusions of rituximab and 3 4-day cycles of dexamethasone (4R+3Dex), according to a study published in The Journal of Pediatrics

Immunomodulation is the most commonly utilized therapeutic approach for patients with ITP initially, but there is a need for additional treatment methods for persistent disease. Previous studies have demonstrated that rituximab plus dexamethasone may lead to superior immediate and long-term outcomes.

For this study, researchers treated 33 pediatric patients with persistent/chronic ITP with 4R+3Dex. Eligible study patients had failed at least 1 previous therapy.

The average age of nonresponders to treatment was 7.75 years, and the average of patients who displayed an initial treatment response was 12.69 years (P =.0073) regardless of gender.

Related Articles

Of the 15 patients who initially responded to treatment, 40% relapsed within the 5-year follow-up after completion of 4R+3Dex. Of the initial responders, 2 patients achieved a partial response and 13 patients achieved a complete response (CR). Patients had similar initial response rates regardless of gender, but of the 10 patients who maintained CR only 2 were male patients and 8 were female patients with ITP less than 24 months prior to treatment.

The authors concluded, “[t]his provides a new therapeutic paradigm for a subpopulation with hard-to-treat chronic ITP. The pathophysiology of ITP underlying this distinction requires further elucidation.”

Reference

  1. Oved JH, Lee CSY, Bussel HB. Treatment of children with persistent and chronic idiopathic thrombocytopenic purpura: 4 infusions of rituximab and three 4-day cycles of dexamethasone. J Pediatrics. 2017;191:225-231. doi: 10.1016/j.jpeds.2017.08.036

This article originally appeared on ONA