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Objective:To evaluate the efficacy and safety as well as the effects of lower dose of rituximab on B-lymphocytes and anti-platelet glycoprotein-specific antibodies in patients with immune thrombocytopenic purpura(ITP). Methods:Twenty ITP patienents, median age forty-seven(twenty to sixty) years old, received intravenous rituximab at the dose of 100mg once weekly for consecutive four weeks, not accompanied with immunosuppressive agents, chemotherapy agents, anticoagulants, corticosteroid therapies. Lab studies included complete blood cell count, serum concentration of IgG, IgM and IgA. CD3+、CD4+、CD8+、CD19+、CD20+cell numbers were assayed by flow cytometry prior to and following rituximab therapy. The respons criteria was refered to international working group of ITP. Peripheral blood CD19+、CD20+cell counts, hemoglobin, white blood cell counts were compared by paired T test, with P< 0.05 as statistically significant difference. Results:A complete response(platelet counts≥100×109/L) was achieved in eleven cases, a response (platelet counts between 50×109/L and 100×109/L) in four cases, and no response(platelet counts<50×109/L) in five cases. Responses were sustained two to twenty-one months(median six months),one case relapsed of these effective cases. After four weeks of lower dose of rituximab therapy, CD 19+、CD20+cells were almost deplete in all patients [(125.65±14.12)×106/Lvs (50.53±29.11)x 106/L, P＜0.01].As expected, the serum concentration of IgG, IgM, IgA and the T cell counts were not changed after therapy. Two patient got infusion-related reaction, one patient got seccondary infections. Conclusion:Treatment with lower dose rituximab may be an effective and safe approach in patient with ITP, However, the optimal therapeutic schedule, long-term efficacy, adverse events need to further investigation.
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