Rituximab and Prednisone as First-Line Therapy in Treating Patients With Immune Thrombocytopenic Purpura

DISEASE CHARACTERISTICS: * Diagnosis of immune thrombocytopenic purpura (ITP) * Diagnosis must be made according to American Society of Hematology diagnostic guidelines by a member of Mayo Rochester's Division of Hematology/Oncology within the past year * ITP must be confirmed by bone marrow aspiration and biopsy in all patients ≥ 60 years of age\* * Bone marrow studies performed outside Mayo must be reviewed by a Mayo hematopathologist to confirm diagnosis and exclude evidence of other hematologic disorders NOTE: \*Bone marrow evaluation is discretionary for all other patients * Requires treatment, as defined by 1 of the following parameters: * Platelet count ≤ 30,000/mm³ * Platelet count ≤ 50,000/mm³ with episodic bleeding (i.e., spontaneous or with minimal trauma) requiring treatment * No concurrent diagnosis of a condition known to cause secondary immune (or nonimmune) thrombocytopenia, including, but not limited to, any of the following: * Rheumatological conditions, such as lupus, rheumatoid arthritis, scleroderma, or mixed connective tissue disorder * Patients with positive serologies and no concurrent, clinically evident condition are eligible * HIV positive or AIDS * Non-Hodgkin's lymphoma, Hodgkin's lymphoma, chronic lymphocytic lymphoma, multiple myeloma, or other malignant hematological conditions * Clinically evident antiphospholipid antibody syndrome\* or heparin-induced thrombocytopenia * Clinically overt liver disease, hepatitis…