PMID- 34665865
OWN - NLM
STAT- MEDLINE
DCOM- 20220307
LR  - 20220307
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Linking)
VI  - 139
IP  - 3
DP  - 2022 Jan 20
TI  - All-trans retinoic acid plus low-dose rituximab vs low-dose rituximab in 
      corticosteroid-resistant or relapsed ITP.
PG  - 333-342
LID - 10.1182/blood.2021013393 [doi]
AB  - The study aimed to compare the efficacy and safety of all-trans retinoic acid 
      (ATRA) plus low-dose rituximab (LD-RTX) with LD-RTX monotherapy in 
      corticosteroid-resistant or relapsed immune thrombocytopenia (ITP) patients. 
      Recruited patients were randomized at a ratio of 2:1 into 2 groups: 112 patients 
      received LD-RTX plus ATRA, and 56 patients received LD-RTX monotherapy. Overall 
      response (OR), defined as achieving a platelet count of >/=30 x 109/L confirmed on 
      >/=2 separate occasions (>/=7 days apart), at least a doubling of the baseline 
      platelet count without any other ITP-specific treatment, and the absence of 
      bleeding within 1 year after enrollment, was observed in more patients in the 
      LD-RTX plus ATRA group (80%) than in the LD-RTX monotherapy group (59%) 
      (between-group difference, 0.22; 95% CI, 0.07-0.36). Sustained response (SR), 
      defined as maintenance of a platelet count >30 x 109/L, an absence of bleeding, 
      and no requirement for any other ITP-specific treatment for 6 consecutive months 
      after achievement of OR during 1 year following enrollment, was achieved by 68 
      (61%) patients in the combination group and 23 (41%) patients in the monotherapy 
      group (between-group difference, 0.20; 95% CI, 0.04-0.35). The 2 most common 
      adverse events (AEs) for the combination group were dry skin and headache or 
      dizziness. Our findings demonstrated that ATRA plus LD-RTX significantly 
      increased the overall and sustained response, indicating a promising treatment 
      option for corticosteroid-resistant or relapsed adult ITP. This study is 
      registered at www.clinicaltrials.gov as #NCT03304288.
CI  - (c) 2022 by The American Society of Hematology.
FAU - Wu, Ye-Jun
AU  - Wu YJ
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing, China.
AD  - Collaborative Innovation Center of Hematology, Peking University, Beijing, China.
AD  - Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 
      China.
AD  - National Clinical Research Center for Hematologic Disease, Beijing, China.
FAU - Liu, Hui
AU  - Liu H
AD  - Department of Hematology, Beijing Hospital, Ministry of Health, Beijing, China.
FAU - Zeng, Qiao-Zhu
AU  - Zeng QZ
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing, China.
AD  - Collaborative Innovation Center of Hematology, Peking University, Beijing, China.
AD  - Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 
      China.
AD  - National Clinical Research Center for Hematologic Disease, Beijing, China.
FAU - Liu, Yi
AU  - Liu Y
AD  - Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing, China.
FAU - Wang, Jing-Wen
AU  - Wang JW
AD  - Department of Hematology, Beijing Tongren Hospital, Capital Medical University, 
      Beijing, China.
FAU - Wang, Wen-Sheng
AU  - Wang WS
AD  - Department of Hematology, Peking University First Hospital, Beijing, China.
FAU - Jia-Feng
AU  - Jia-Feng
AD  - Department of Hematology, Peking University Shenzhen Hospital, Shenzhen, China; 
      and.
FAU - Zhou, He-Bing
AU  - Zhou HB
AD  - Department of Hematology, The Affiliated Beijing Luhe Hospital of Capital Medical 
      University, Beijing, China.
FAU - Huang, Qiu-Sha
AU  - Huang QS
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing, China.
AD  - Collaborative Innovation Center of Hematology, Peking University, Beijing, China.
AD  - Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 
      China.
AD  - National Clinical Research Center for Hematologic Disease, Beijing, China.
FAU - He, Yun
AU  - He Y
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing, China.
AD  - Collaborative Innovation Center of Hematology, Peking University, Beijing, China.
AD  - Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 
      China.
AD  - National Clinical Research Center for Hematologic Disease, Beijing, China.
FAU - Fu, Hai-Xia
AU  - Fu HX
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing, China.
AD  - Collaborative Innovation Center of Hematology, Peking University, Beijing, China.
AD  - Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 
      China.
AD  - National Clinical Research Center for Hematologic Disease, Beijing, China.
FAU - Zhu, Xiao-Lu
AU  - Zhu XL
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing, China.
AD  - Collaborative Innovation Center of Hematology, Peking University, Beijing, China.
AD  - Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 
      China.
AD  - National Clinical Research Center for Hematologic Disease, Beijing, China.
FAU - Jiang, Qian
AU  - Jiang Q
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing, China.
AD  - Collaborative Innovation Center of Hematology, Peking University, Beijing, China.
AD  - Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 
      China.
AD  - National Clinical Research Center for Hematologic Disease, Beijing, China.
FAU - Jiang, Hao
AU  - Jiang H
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing, China.
AD  - Collaborative Innovation Center of Hematology, Peking University, Beijing, China.
AD  - Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 
      China.
AD  - National Clinical Research Center for Hematologic Disease, Beijing, China.
FAU - Chang, Ying-Jun
AU  - Chang YJ
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing, China.
AD  - Collaborative Innovation Center of Hematology, Peking University, Beijing, China.
AD  - Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 
      China.
AD  - National Clinical Research Center for Hematologic Disease, Beijing, China.
FAU - Xu, Lan-Ping
AU  - Xu LP
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing, China.
AD  - Collaborative Innovation Center of Hematology, Peking University, Beijing, China.
AD  - Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 
      China.
AD  - National Clinical Research Center for Hematologic Disease, Beijing, China.
FAU - Huang, Xiao-Jun
AU  - Huang XJ
AUID- ORCID: 0000-0002-2145-6643
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing, China.
AD  - Collaborative Innovation Center of Hematology, Peking University, Beijing, China.
AD  - Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 
      China.
AD  - National Clinical Research Center for Hematologic Disease, Beijing, China.
FAU - Zhang, Xiao-Hui
AU  - Zhang XH
AUID- ORCID: 0000-0003-4730-256X
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing, China.
AD  - Collaborative Innovation Center of Hematology, Peking University, Beijing, China.
AD  - Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 
      China.
AD  - National Clinical Research Center for Hematologic Disease, Beijing, China.
LA  - eng
SI  - ClinicalTrials.gov/NCT03304288
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Immunologic Factors)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 5688UTC01R (Tretinoin)
SB  - IM
CIN - Blood. 2022 Jan 20;139(3):307-308. PMID: 35050337
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Adult
MH  - Antineoplastic Agents/administration & dosage/*therapeutic use
MH  - Drug Resistance
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Immunologic Factors/administration & dosage/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Purpura, Thrombocytopenic, Idiopathic/*drug therapy
MH  - Recurrence
MH  - Rituximab/administration & dosage/*therapeutic use
MH  - Secondary Prevention
MH  - Tretinoin/administration & dosage/*therapeutic use
EDAT- 2021/10/20 06:00
MHDA- 2022/03/08 06:00
CRDT- 2021/10/19 17:20
PHST- 2021/07/19 00:00 [received]
PHST- 2021/10/13 00:00 [accepted]
PHST- 2021/10/20 06:00 [pubmed]
PHST- 2022/03/08 06:00 [medline]
PHST- 2021/10/19 17:20 [entrez]
AID - S0006-4971(21)01759-6 [pii]
AID - 10.1182/blood.2021013393 [doi]
PST - ppublish
SO  - Blood. 2022 Jan 20;139(3):333-342. doi: 10.1182/blood.2021013393.