[PAGID] Cellcept for ITP and CVID

[Chris Seroogy]

Dear Mel,

375 mg/m2 weekly x 4.  Her spleen is normal in size per physical exam.
Chris


On 5/7/08 1:34 PM, "Berger, Melvin" <Melvin.Berger at UHhospitals.org> wrote:


> 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

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