Two patients, a 4-year-old boy and a 6-year-old girl who had a 2-year
and a 3-year history of idiopathic thrombocytopenic purpura,
respectively, were referred to our Department. Both patients had
frequent haemorrhagic events. They received i.v. immunoglobulin,
corticosteroids, cyclosporine, interferon alpha-2b and azathioprine, but
no clinical remission was established. The girl also underwent
splenectomy. Anti-CD20 antibody was administered to both patients at a
dose of 375 mg/m(2) once weekly for 4 weeks. No side-effects were
detected. During the 18-month follow-up period the patients received no
other drug and remained in clinical remission. The B lymphocytes
remained undetectable in peripheral blood for 3 months and they
progressively increased during the following 4 months. Rituximab is a
novel, quite effective, safe treatment of chronic refractory idiopathic
thrombocytopenic purpura in childhood. More studies and follow up of
patients for longer periods are necessary
