Rituximab as Second Line Treatment for ITP

Exclusion Criteria

• •1. Previous splenectomy, chemotherapy, treatment with anti-D Ig, rituximab, or immune-suppressive treatments other than corticosteroids, Dapsone or Danazol
• •2. Underlying malignancy or previous history of malignancy in the past 5 years (except skin carcinoma)
• •3. Pregnancy and lactation
• •4. Not willing to participate in the study
• •5. Expected survival of \< 2 years
• •6. Known intolerance to murine antibodies
• •7. Females in child-bearing age not willing to use contraception for 6 months
• •8. HIV-positive/AIDS-, Hepatitis -B virus positive- or Hepatitis -C virus positive
• •9. Patients with a definite Systemic Lupus Erythematosus (SLE) (\> 4 of the American College of Rheumatology Criteria)
• •10. Patients currently involved in another clinical trial with evaluation of drug treatment
• •11. Bacterial infections, viral infections, fungal infections, myco-bacterial infections (excluding fungal infections) or other evolutive infections or any other infections episode requiring hospitalisation or treatment with an antibiotics 4 weeks before selection for IV route or within 2 weeks before selection for oral route
• •12. History of soft tissue, bone or joint infections (fascitis, abscess, osteomyelitis, septic arthritis) during the last year prior to inclusion in the study
• •13. Medical history of relapsing or chronic severe infectious diseases or any other underlying pathology predisposing to serious infections
• •14. Known Primary or secondary immune deficiency syndromes
• •15. Administration of a living vaccine within 4 weeks preceding the inclusion in the study -16- Previous treatment with any lymphocytes depleting medication (e.g.: MabCampath®)
• •17- Previous treatment with inhibitors of leucocytes transmigration (e.g.: Tysabri®) 18- Known intolerance to human monoclonal antibodies 19- Known severe chronic pulmonary obstructive Disease (FEV \< 50% or functional dyspnoea grade 3) 20- Known congestive heart failure NYHA (New York Heart Association classification of heart failure) class III and IV 21- Recent episode (\<6 months) of acute coronary syndrome.