Urgent ! abandon rituxan and start promacta ?

Hello all,


i have urgent question. wife platelet currently @10k for about 2 weeks. currently hospitalized and not reponding to steroid/dexa, anything , etc after delivering baby 2 months ago. she was spenectomied about 20 years ago, diagnosed about 25 years ago. before delivering baby, her count always stable at 50k after spenectomy done and never take any medicine.

wife has urgent needs to raise platelet count due to stomach problem (no bleeding yet or maybe some small bleeding happened), but passed out a lot due to lots of pain.

wife took 1 dose of rituxan last weekend, but platelet stay at 10k. do we take another dose of rituxan this wekeend, or abandon and switch to promacta. or do both

is it ok to take both rituxan and promacta? i've tried to research this issue but found nothing.

thanks

Rituxan can take 4 to 12 weeks after the first infusion to work. I wouldn't give up just yet. I don't know that I'd do both Rituxan and Promacta. Getting counts too high could cause clots.

some update:

After 1 dose of rituxan, she contacted with pneumonia. Rituxan probably wiped out her antibody, but platelet remains low in arround 10 - 15k even with some round of IVIG. after 3 weeks in intensive care due to pneumonia, we switch hema. new hema prescribed Promacta. Promacta able to raise her platelet to arround 60k.

then she had a pain on left abdomen, so hema order a ct scan and found 2 acessories spleen in which one of them as big as an egg. the other is small around 2cm.

2nd splenectomy done last month to removed these 2 acessories spleen.. her platelet is now stabilize in arround 90k. this count without steroid/promacta.

some more questions:
1. she is experiencing massive hair loss. is this common due to daily promacta / steroid intake?
2. she also have some joint pain and finger stiffness especially in the morning. hema do some lupus test, result is negative. any one experience this after taking promacta?

About hair loss--I think big-time hair loss is fairly common a month or so after any big shock to the body. Could be brought on by anesthesia and/or surgery, I've been told, as well as ITP treatments.

I would finish the Rituxin treatment and see how she responds. It can take several weeks after the last treatment before results can be seen. I would not do both Promacta and Rituxin.