Rituximab Use in Children

Indications for Rituximab in Pediatric Patients

• The American Society of Hematology recommends rituximab as a second-line treatment option for children with chronic refractory immune thrombocytopenia (ITP) with response rates between 31-68%, but should be reserved for those with significant ongoing bleeding despite first-line therapies 1, 2, 3
• Rituximab is indicated for children with chronic refractory ITP who have significant ongoing bleeding despite treatment with IVIg, anti-D, or conventional doses of corticosteroids (grade 2C) 4, 5
• Rituximab may be considered as an alternative to splenectomy in children and adolescents with chronic ITP or in patients who do not respond favorably to splenectomy (grade 2C) 4, 6

Dosing in Children

• For ITP, the recommended dose is 375 mg/m² weekly for 4 doses 1

Efficacy in Pediatric ITP

• Response rate (platelet count ≥50 × 10⁹/L) ranges between 31% and 68% in children with chronic refractory ITP 1, 3
• Rituximab should be considered after failure of first-line therapies (IVIg, IV anti-D, short-course corticosteroids) 1, 4

Safety and Adverse Events

• Serum sickness can occur following rituximab administration 1