Document Detail


Efficacy and safety of rituximab in common variable immunodeficiency-associated immune cytopenias: a retrospective multicentre study on 33 patients.
MedLine Citation:
PMID:  21981575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with common variable immunodeficiency (CVID) are at high risk of developing immune thrombocytopenia (ITP) and/or autoimmune haemolytic anaemia (AHA). Given their underlying immunodeficiency, immunosuppressive treatment of these manifestations may increase the risk of infection. To assess efficacy and safety of rituximab in patients with CVID-associated ITP/AHA, a multicentre retrospective study was performed. Thirty-three patients, 29 adults and four children, were included. Patients received an average of 2·6 treatments prior to rituximab including steroids, intravenous immunoglobulin and splenectomy (21%). The median ITP/AHA duration at time of first rituximab administration was 12 months [range 1-324] and the indication for using rituximab was ITP (22 cases), AHA (n = 5) or both (n = 7); 1 patient was treated sequentially for ITP and then AHA. The overall initial response rate to rituximab was 85% including 74% complete responses. After a mean follow-up of 39 ± 30 months after rituximab first administration, 10 of the initial responders relapsed and re-treatment with rituximab was successful in 7/9. Severe infections occurred after rituximab in eight adults (24%), four of whom were not on immunoglobulin replacement therapy. In conclusion, rituximab appears to be highly effective and relatively safe for the management of CVID-associated severe immune cytopenias.
Authors:
Delphine Gobert; James B Bussel; Charlotte Cunningham-Rundles; Lionel Galicier; Agnès Dechartres; Alice Berezne; Bernard Bonnotte; Thierry DeRevel; Christophe Auzary; Roland Jaussaud; Claire Larroche; Alain LeQuellec; Marc Ruivard; Pascal Seve; Amar Smail; Jean-François Viallard; Bertrand Godeau; Olivier Hermine; Marc Michel
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2011-10-08
Journal Detail:
Title:  British journal of haematology     Volume:  155     ISSN:  1365-2141     ISO Abbreviation:  Br. J. Haematol.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-28     Completed Date:  2012-03-01     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  0372544     Medline TA:  Br J Haematol     Country:  England    
Other Details:
Languages:  eng     Pagination:  498-508     Citation Subset:  IM    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Department of Internal Medicine, Hôpital Henri Mondor, Créteil, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anemia, Hemolytic, Autoimmune / drug therapy*,  immunology
Antibodies, Monoclonal, Murine-Derived / adverse effects,  therapeutic use*
Child
Common Variable Immunodeficiency / blood,  drug therapy*
Female
Humans
Male
Middle Aged
Retrospective Studies
Thrombocytopenia / drug therapy*,  immunology
Young Adult
Grant Support
ID/Acronym/Agency:
P01 AI061093/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal, Murine-Derived; 0/rituximab
Comments/Corrections

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