Sustained remission of platelet counts following monoclonal anti-CD20 antibody therapy in two cases of idiopathic autoimmune thrombocytopenia and neutropenia
M. Faurschou et al., Sustained remission of platelet counts following monoclonal anti-CD20 antibody therapy in two cases of idiopathic autoimmune thrombocytopenia and neutropenia, EUR J HAEMA, 66(6), 2001, pp. 408-411
Idiopathic autoimmune thrombocytopenia and neutropenia (ITN) is a primary h
aemocytopenic disorder clinically characterised by recurrent mucocutaneous
bleeding episodes and infections. Unlike in simple idiopathic thrombocytope
nic purpura. the platelet deficiency of ITN tends to be chronic and difficu
lt to treat. We describe two patients with ITN who obtained sustained remis
sion of their platelet counts after therapy with the chimeric monoclonal an
ti-CD20 antibody Rituximab. In one of two cases, Rituximab also induced pro
longed normalisation of the neutrophil count and disappearance of auto-anti
bodies. Our observations indicate that disturbed B-cell function plays a ce
ntral role in the pathogenesis of ITN. Anti-CD20 antibody therapy seems to
constitute a safe and efficient alternative to corticosteroids for the mana
gement of ITN patients with chronic thrombocytopenia.