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4CPS-190 Rituximab use in children, a single hospital experience
  1. M Pallares Borras1,
  2. A Comes Escoda1,
  3. F Bossacoma Busquets1,
  4. AD Madrid Aris2,
  5. M Sánchez Celma1,
  6. J Arrojo Suarez1,
  7. J Vinent Genestar1,
  8. A Martínez Deyà3,
  9. L Alsina Manrique de Lara3
  1. 1Hospital Sant Joan de Déu, Pharmacy, Esplugues de Llobregat, Spain
  2. 2Hospital Sant Joan de Déu, Nephrology, Esplugues de Llobregat, Spain
  3. 3Hospital Sant Joan de Déu, Clinical Immunology, Esplugues de Llobregat, Spain


Background Rituximab is a monoclonal antibody directed against the CD20 antigen, expressed on the surface of B-lymphocytes, promoting the lyses of the cells. It is labelled for adult different indications, non-Hodgkin’s lymphoma, chronic lymphocytic leukaemia (CLL), rheumatoid arthritis and granulomatosis with polyangiitis and microscopic polyangiitis. Nowadays it is commonly used as an off-label treatment for many other diseases, including some paediatric disorders.

Purpose To describe the patterns of rituximab use in a paediatric teaching hospital.

Material and methods We conducted a retrospective observational study involving all patients treated in a paediatric hospital with rituximab from January 2001 to June 2018.

Clinical data were collected from electronic patients’ medical records, including: patient age, prescribing services and indication.

Results The study comprised 145 patients (39% males) with a median age of 15.4 years. The principal indications according to the prescribing services were:

  • Forty–seven patients of the nephrology unit: resistant or refractory nephrotic syndrome (34) and transplants–rejects (13).

  • Forty patients of the oncology unit: non–Hodgkin lymphoma (23), syndrome opsoclonus–myoclonus in neuroblastoma (14) and others (three).

  • Twenty–five patients of the haematology unit: disease: haemolytic anaemia (11), leukaemia (four), haemophagocytic syndrome (four), thrombocytopenic purpura (two) and others (four).

  • Thirteen patients of the rheumatologic diseases unit: juvenile idiopathic arthritis (four), systemic lupus erythematosus (four), vasculitis (two) and others (three).

  • Twelve patients of the neurology unit: autoimmune encephalitis (nine), post–Herpes Simplex encephalitis (two) and others (one).

  • Seven patients of the infectious unit: Epstein–Barr virus infection (seven).

  • One dermatologic disease: Steven–Johnson disease (one).

  • No unexpected side effects were observed outside those reported in the summary characteristics of the product.

Conclusion In paediatrics, rituximab treatment is prescribed for off-label indications. Our study shows that rituximab is used in a wide variability of disorders, where the renal disease, specifically the nephrotic syndrome, is the most common indication as a second-line treatment.

Although the utilisation of rituximab increases every year and some uses are well described, further studies for some indications are necessary to establish a correct safety and efficacy profile in children.

References and/or acknowledgements To the pharmacy, oncology, haematology, immunology and nephrology staff.

No conflict of interest.

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