Severe hematological side effects following Rituximab therapy in children

Rituximab use in severe auto-immune diseases has recently increased. Scattered reports of opportunistic infections were the only reported serious side effects related to rituximab in pediatric patients .Here, we report transient severe acute thrombocytopenia and neutropenia respectively a few days after rituximab infusion in two children with autoimmune haemolytic anaemia. In both cases, cytopenia was reversible in a few days. The occurrence of cytopenias shortly after an infusion and their rapid reversibility suggest that these hematological side-effects were attributable to a direct toxicity of rituximab. Blood cell count must be carefully monitored after rituximab infusion in young children with autoimmune diseases.