Weekly Rapid Infusion Rituximab Treatment in Immune Thrombocytopenic Purpura and Autoimmune Hemolytic Anemia: Is It Safe and Effective?

Abstract

Aim: The study aimed to assess the safety and efficacy of weekly rapid infusion rituximab in patients with immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia (AIHA). Rituximab is widely used for various hematological and autoimmune conditions but can cause infusion-related reactions (IRRs), particularly during initial infusions. Traditional infusion methods are time-consuming and affect hospital stay and healthcare resources. This study aimed to evaluate whether a rapid infusion protocol can address these challenges while maintaining safety and efficacy. Material and Method: This retrospective, single-arm study included 29 patients (22 ITP, 7 AIHA). Patients received rituximab at 375 mg/m² weekly for four doses using a rapid infusion protocol. The primary outcomes were safety and efficacy. Cost-effectiveness was evaluated based on hospital stay duration and resource use. Results: Rapid infusion of rituximab was well tolerated, with only 2 of 116 infusions resulting in Grade 1 IRRs (nausea). No severe adverse reactions were reported. In the ITP group, 66% achieved complete response (CR) and 26% had partial response (PR). In the AIHA group, 50% of patients achieved CR and 50% achieved PR. Post-treatment, the hemoglobin and platelet counts improved significantly. The study also noted reduced hospital stay and healthcare resource utilization. Conclusion: Weekly rapid infusion of rituximab is safe and effective for ITP and AIHA patients and offers advantages in terms of time, cost, and patient comfort. The low incidence of IRRs and high response rates suggest that it could replace the traditional infusion methods. However, larger multicenter studies with long-term follow-up are required to confirm these findings.