Refractory severe connective tissue disease thrombocytopenia: is rituximab treatment effective and safe?

W J Zheng, X Zhang, Q Wang, D Xu, X F Zeng, F C Zhang

Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China

Correspondence to:
X Zhang, Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; zxpumch2003@yahoo.com.cn

Accepted 5 September 2008

The first 150 words of the full text of this article appear below.

Rituximab, a chimeric monoclonal antibody against B cell-specific surface marker CD20, has shown encouraging results in treating autoimmune diseases.^1–4

In this study, six patients with refractory severe thrombocytopenia (platelets (PLT) 4 to 10x10⁹/litre) were treated with rituximab (weekly infusion of 375 mg/m² for 3–4 consecutive weeks), including three cases of systemic lupus erythematosus, one case each of primary Sjögren syndrome, undifferentiated connective tissue disease (CTD) and antiphospholipid syndrome (APS). Previous corticosteroids and immunosuppressive agents in all patients were continued. Disease durations were 3 months to 13 years. Prior to rituximab therapy, all patients had failed at least two courses of methylprednisolone pulse (1 g per day for 3 consecutive days) in combination with intravenous immunoglobulin (20 g per day for 3 to 5 consecutive days) plus at least two immunosuppressants, including cyclophosphamide, vincristine, mycophenolate mofetil and/or ciclosporine A. Patients 2, 4 and 5 had also undergone splenectomy . . . [Full text of this article]

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