Abstract
Objective:To discuss clinical effect of different dosage of rituximab combined with cyclophosphamide in treatment of refractory immune thrombocytopenia (rITP).Method:This study was conducted at Department of Hematopathology in XX Hospital from January 2016 to January 2018. In this study. Seventy-eight patients with rITP were selected as the objects, divided into observation group (39 cases) and control group (39 cases) according to random number table. Patients in the control group were treated with conventional rituximab and cyclophosphamide, while the observation group received low-dose rituximab. The same amount of cyclophosphamide was used in the two groups. The statistics of clinical effect, recurrence rate, untoward effect and Laboratory inspection of both groups were made before and after the treatment.Results:Compared with the control group, the total occurrence rate of side effects in the observation group decreased significantly; the level of IgM and CD20+ in the observation group also decreased significantly, while. The level of IgA, IgG, CD3+ and CD4+ rose significantly (P<0.05). The differences in the level of Th1, TNF-a, IL-18 and Sc5b-9 had statistical significance before and after the treatment (P<0.05).Conclusion:Rituximab combined with cyclophosphamide has the definite curative effect on rITP. The small dosage of rituximab combined with cyclophosphamide has higher clinical safety in the treatment.
Highlights
Primary immune thrombocytopenia (ITP), called idiopathic thrombocytopenic purpura, is a common hemorrhagic disease.[1,2] At present, the pathogenesis of ITP is not clear
About 70% of patients choose glucocorticoid, immune globulin, splenectomy and immunosuppressor,[4] where 20~30% of patients with ITP turn into refractory immune thrombocytopenia (rITP) due to treatment failure or reoccurrence.[5]
Rituximab as the second-line treatment medicine of ITP is recommended to treat rITP
Summary
Primary immune thrombocytopenia (ITP), called idiopathic thrombocytopenic purpura, is a common hemorrhagic disease.[1,2] At present, the pathogenesis of ITP is not clear. Even if the high dosage of conventional medicine is used, it is still difficult to
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