[PAGID] Cellcept for ITP and CVID

[Berger, Melvin]

You don't give details, but have you tred pushing the dose of Rituxin ? We have had very good success with Rituxin in CVID patients with cytopenia. Since they are already on IGIV we don't worry so much about it having adverse effecs on protective antibody responses. 

Does the patient have a big spleen ?

Mel Berger

-----Original Message-----
From: pagid-bounces at list.clinimmsoc.org [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Chris Seroogy
Sent: Wednesday, May 07, 2008 11:46 AM
To: pagid at list.clinimmsoc.org
Subject: [PAGID] Cellcept for ITP and CVID

Hello,

Has anyone had success using cellcept for ITP in CVID patients?  I have a
teenager who presented a number of years ago with ITP and AIHA.  She
fulfills the criteria for CVID and is on IVIG.  She had a recent flare in
her ITP and failed increasing her IVIG.  She was started on prednisone and
rituxan.  She just finished her fourth cycle of rituxan and is tapering on
her prednisone.  She responded nicely (I think more to the steroids than the
rituxan since the response was early and rapid) but now her platelets are
slowly dropping.  As opposed to offering splenectomy, I was thinking of
cellcept since I think the risk/benefit is better in general.  Thank you for
sharing your experiences.  Chris


Chris Seroogy, M.D.

University of Wisconsin

Assistant Professor

Dept. of Pediatrics

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