Clinical studies of small doses of rituximab in treating chronic idiopathic thrombocytopenic purpura

Objective To study the effect of small doses of rituximab on chronic idiopathic thrombocytopenic purpura(ITP).Methods From February 2012 to February 2013,in the People's Hospital of Anyang,a total of 58 patients were diagnosed as chronic ITP.They were randomly divided into the observation group(29 cases) and the control group (29 cases),the patients in the control group were treated with dexamethasone,40 mg/d,intravenous drip,lasted for 4 d,while the patients in the observation group were treated with small doses of rituximab,100 mg/times,intravenous drip,1 time/week,lasted for 4 weeks.The effects on platelet recovery,platelet antibody levels as well as the level of immune cells were observed.Results The total effective rate was 65.52％ (19/29) in the observation group,which was significantly higher than that in the control group [37.93％ (11/29)].There were significant differences (P ＜ 0.05).The PAIgG level in the observation group after treatment was (50.15 ± 49.91)ng/107,which was significantly lower than that before treatment [(133.04 ±117.69)ng/107 PAL],and that in the control group after treatment (77.23 ±50.11)ng/107 PAL].The PLT level in the observation group after treatment was (72.13 ±0.42) × 109/L,which was significantly lower than that before treatment [(9.32 ± 0.57) × 109/L],and the control group after treatment [(48.56 ±0.63) × 109/L].After treatment,CD19+ CD20+ was 107 ± 89 in the observation group,which was significantly less than that before treatment (368 ± 274),and that in the control group after treatment (241 ± 143); CD4+ CD25 + FOXP3-was 6.5 ± 4.2 in the observation group after treatment,which was significantly lower than that before treatment (10.4 ± 9.3),and that in the control group after treatment (8.8 ± 4.3).There were significant differences (Pall ＜ 0.05).Conclusions Small dose of rituximab in the treatment of chronic ITP,can significantly reduce platelet related antibodies,improve patients' immune cell function and elevate the level of platelet,which has good efficacy and is worthy of clinical recommendation. Key words: Small doses;  Rituximab;  Chronic idiopathic thrombocytopenic purpura;  Research