Antimicrobial prophylaxis in patients with immune thrombocytopenia treated with rituximab: a retrospective multicenter analysis

Marco Santoro, Mariasanta Napolitano, Sergio Siragusa, Simona Raso, Giuseppina Calvaruso, Alessandro Lucchesi, Donato Mannina, Paolo Silimbani, Giulio Giordano, Francesco Reale, Aurelio Maggio, Ugo Consoli, Aurelio Maggio, Giulia Arrigo

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The primary aim of this study was to describe the use of primary anti-infective prophylaxis (AP) in common clinical practice inpatients affected by immune thrombocytopenia (ITP) and treated with RTX. Population studied consisted of patients affected byITP (age ≥ 18 years) who had received at least one dose of RTX from January 2008 to June 2018. Five Italian haematologycentres participated in the current study. Data were retrospectively collected: demographic data (age, gender), concomitantcomorbidities and previous therapies for ITP, characteristics of AP, the occurrence of infections and their management. TheITP cohort consisted of 67 patients sub-grouped into two categories according to the administration of AP: (1) treated with AP(N= 34; 51%) and (2) not treated with AP (N=33, 49%). AP consisted of combined trimethoprim/sulfamethoxazole (TMP/SMX)and acyclovir (AC) in half of patients. TPM/SMX as a single agent was adopted in 32% patients and one patient received onlyAC. Overall, infections were experienced in 15% of patients during follow-up with a similar proportion in the 2 groups (treatedand not treated) of patients (14.7% vs 15%). Clinical course of infections was however, less severe in patients treated with AP,where all infections were grade 2 and did not require hospitalization. In neither group of patients was reported Pneumocystispneumonia. In conclusion, despite the absence of clear evidence, our analysis shows that AP in patients with ITP receiving RTXis frequently adopted, even if in the absence of well-defined criteria. Prophylaxis administration is quite consistent within thesame haematological Center; thus, it seems related to clinicians’ experience
Lingua originaleEnglish
Numero di pagine7
RivistaAnnals of Hematology
Stato di pubblicazionePublished - 2021

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