Rituximab for the treatment of acute refractory ITP.

Most children with acute immune thrombocytopenic purpura (ITP) respond to first-line therapies including intravenous immunoglobulin, corticosteroids, and Rho(D) immune globulin. However, there is no clear consensus regarding second-line therapies for the treatment of ITP, not responding to first-line therapies in the acute setting. Adapting from the chronic ITP literature, 3 patients with acute refractory ITP were treated with intravenous rituximab and showed immediate and sustained remission. Combined therapy that includes rituximab may be an effective regimen for acute refractory ITP.