Rituximab-Induced Thrombocytopenia and Immune Thrombocytopenia Treatment

Rituximab in ITP Treatment

The American Society of Hematology recommends rituximab as a treatment for immune thrombocytopenia (ITP), with response rates of approximately 60% of patients, complete response in about 40% of ITP patients, and responses typically occurring after 1-8 weeks of treatment 1
For ITP patients, rituximab may be considered for those with significant ongoing bleeding despite first-line treatments, as an alternative to splenectomy in chronic ITP, and in combination with corticosteroids in certain cases, though evidence suggests corticosteroids alone may be preferred for initial therapy 2
The use of rituximab in combination with corticosteroids for ITP treatment has been studied, with evidence suggesting that corticosteroids alone may be preferred for initial therapy 3

The American College of Physicians recommends close monitoring of platelet counts, complete blood count (CBC), hepatic and renal function tests, and immunoglobulin levels with long-term use of rituximab 4
Rituximab can cause progressive multifocal leukoencephalopathy, a rare but serious adverse effect, and hypogammaglobulinemia with long-term use, as reported by the FDA and other guideline societies 5