Authors

Huijuan Ren*, Xiaotian Su*, Jili Wen**, #

Departments

*Department of Hematology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, PR China - **Department of Emergency, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, PR China

Abstract

Objective: This study was designed to investigate the effects of a low dose of rituximab on T-cell subsets and platelet-associated immunoglobulin in patients with primary immune thrombocytopenia. 

Methods: A total of 96 primary immune thrombocytopenia (ITP) patients treated in our haematology department from May 2017 to February 2019 were randomly selected and divided into a control group and research group, with 48 cases in each group. Both groups were given blood routine examinations and liver function examinations during treatment. The vital signs of the patients were observed throughout. As the platelet count of the patients was below 10×109/L, platelet suspension infusions were given. Meanwhile haemostatic drugs such as aminomethylbenzoic acid were also given. The patients in the control group were treated with prednisone acetate and the patients in the research group treated with rituximab. After 8 weeks of continuous treatment, the clinical effects of the two groups were observed. T-cell subsets (CD4+/CD8+, CD3+, CD4+), and PAIgA, PAIgM and PAIgG levels were compared between the two groups. 

Results: The total effective rate of the study group was 93.75% after treatment, which was significantly higher than the control group (79.17%) (P<0.05). After treatment, the levels of CD4+/CD8+, CD3+ and CD4+ in the study group and the control group were significantly higher than in the untreated group, and the levels of CD8+ in the study group were significantly lower than in the untreated group. The levels of CD4+/CD8+, CD3+ and CD4+ in the study group were significantly higher than those in the control group after treatment, and the levels of CD8+ were significantly lower than those in the control group (P<0.05). After treatment, the levels of PAIgA, PAIgM and PAIgG in the study group and the control group were significantly lower than untreated group, and the levels of platelet-related immunoglobulin in the study group were significantly lower than those in the control group after treatment (P<0.05). During the treatment, two adverse reactions occurred in the study group, including osteoporosis and insomnia (4.16%). Eight cases of adverse reactions also occurred in the control group (16.67%), including one case of infection and insomnia, and three cases of osteoporosis and electrolyte disorder; the control group was significantly higher for adverse reactions than the study group (P<0.05). 

Conclusion: A low dose of rituximab is effective in treating ITP. It can significantly improve T-cell subsets and the levels of platelet associated immunoglobulin in ITP patients with a high degree of safety. 

Keywords

Rituximab, primary immune thrombocytopenia, efficacy, T cell subsets, platelet-associated immunoglobulin.

DOI:

10.19193/0393-6384_2020_3_322