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As far as I know, it would be absolutely terrible as a gaming rig.
The reason is because almost all games are 32-bit. Itanium is 64-bit. When you try to run a 32-bit program on it, it slows down dramatically. Note that this does not apply to the "64-bit" desktop processors we have from AMD and Intel. Those are more of a bridge between pure 32-bit and pure 64-bit, meaning they perform well with both.
I believe there is one game out there now that can benefit from 64-bit. I don't know how that game would do on Itanium. But I know that all of the other games would do terribly.
What kind of rig are you looking at anyway? Itanium is meant for servers, which wouldn't have the graphics power needed to run games anyway.
WinXP does not support IA64. The versions of Windows that do support Itanium don't support DirectX. I think you'll also have a hard time finding a Windows video driver for Itanium that supports either DX or OpenGL anyways.
It might be possible to do gaming in Linux/Unix/Solaris/etc if you recompile the game source(s).