All-Trans Retinoic Acid with Low-Dose Rituximab for ITP?

Adding ATRA to low-dose rituximab improved platelet count compared to low-dose rituximab alone.

Standard first-line treatment for immune thrombocytopenia (ITP) includes steroids with or without intravenous immune globulins. However, many patients require second line treatment owing to lack of response, intolerance, or relapse. Many second-line options exist, including rituximab, splenectomy, and thrombopoietin agonists. Some investigators have proposed that combining therapies with complementary mechanisms of action might improve response to the second-line options. A prior study showed efficacy from adding all-trans retinoic acid (ATRA), which can induce megakaryocyte differentiation, to danazol in patients with ITP (Lancet Haematol 2017; 4:e487).

Now, investigators report a randomized, multicenter study comparing ATRA plus low-dose r…

Reviewing Author

Brady L. Stein, MD, MHS

Disclosures

Leadership Positions in Professional SocietiesAmerican Society of Hematology (Senior Editor, ASH Self-Assessment Program; guideline development)

Brady L. Stein, MD, MHS

Disclosures

Leadership Positions in Professional SocietiesAmerican Society of Hematology (Senior Editor, ASH Self-Assessment Program; guideline development)

All-Trans Retinoic Acid with Low-Dose Rituximab for ITP?

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Reviewing Author