A dramatic response to rituximab in a patient with resistant thrombotic thrombocytopenic purpura (TTP) who developed acute stroke

Özdoğu, Hakan; Boğa, Can; Kızılkılıç, Ebru; Yeral, Mahmut; Kozanoğlu, İlknur; Karataş, Mehmet Baran

doi:10.1007/s11239-006-9051-2

Cited by 7 publications

(2 citation statements)

References 14 publications

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“…The time taken for patients with TTP to respond to rituximab ranges from <1 week to 13 weeks (Heidel et al, 2007;Kameda et al, 2007), with one patient achieving a rapid neurological response just 12 h after rituximab therapy (Ozdogu et al, 2007). Furthermore, in some cases, rituximab is effective in patients with TTP with normal ADAMTS13 activity (Reddy et al, 2005;Kameda et al, 2007).…”

Section: Use Of Rituximab In Ttpmentioning

confidence: 99%

Rituximab in the treatment of autoimmune haematological disorders

2008

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SummaryCurrent treatment regimens for haematological autoimmune diseases are relatively non-selective and are often associated with considerable toxicity. Recently, it has become clear that B cells play a key role in both the development and perpetuation of autoimmunity, suggesting that B-cell depletion could be a valuable treatment approach for patients with autoimmune diseases. This article reviews data supporting the use of rituximab -an anti-CD20 monoclonal antibody that specifically depletes B cells -in four key autoimmune haematological disorders: idiopathic thrombocytopenic purpura (ITP); autoimmune haemolytic anaemia (AIHA); acquired haemophilia; and thrombotic thrombocytopenic purpura (TTP). Although treatment of ITP, AIHA, acquired haemophilia and TTP with rituximab is still relatively uncommon, results from case series and small phase II trials indicate that patients of all ages can respond to rituximab, irrespective of the number or type of prior treatments that they have received. Moreover, patients with these diseases receiving rituximab experienced predominantly mild adverse events, with only a few serious adverse events reported. These data suggest that rituximab provides an effective and well-tolerated alternative treatment option for patients with ITP, AIHA, acquired haemophilia and TTP, many of whom have limited treatment choices.

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Section: Use Of Rituximab In Ttpmentioning

confidence: 99%

Rituximab in the treatment of autoimmune haematological disorders

2008

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“…A number of studies have also been conducted in patients with refractory or relapsing TTP. In addition to several case reports and small case series [ 3 , 17 , 69 , 70 , 74 , 99 ], results from the first prospective trial have been published [ 35 ]. This study recruited 11 patients (6 enrolled during an acute refractory phase and 5 during a remission phase); following rituximab therapy (375 mg/m 2 once weekly for 4 weeks), clinical remission was observed in all 6 acute cases, while all 5 patients enrolled during remission remained in clinical remission during the 6–11 month follow-up period.…”

Section: Clinical Use Of Rituximabmentioning

confidence: 99%

The potential utility of B cell-directed biologic therapy in autoimmune diseases

Arkfeld

2007

Rheumatol Int

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Increasing awareness of the importance of aberrant B cell regulation in autoimmunity has driven the clinical development of novel B cell-directed biologic therapies with the potential to treat a range of autoimmune disorders. The Wrst of these drugs-rituximab, a chimeric monoclonal antibody against the B cell-speciWc surface marker CD20-was recently approved for treating rheumatoid arthritis in patients with an inadequate response to other biologic therapies. The aim of this review is to discuss the potential use of rituximab in the management of other autoimmune disorders. Results from early phase clinical trials indicate that rituximab may provide clinical beneWt in systemic lupus erythematosus, Sjögren's syndrome, vasculitis, and thrombocytopenic purpura. Numerous case reports and several small pilot studies have also been published reporting the use of rituximab in conditions such as myositis, antiphospholipid syndrome, Still's disease, and multiple sclerosis. In general, the results from these preliminary studies encourage further testing of rituximab therapy in formalized clinical trials. Based on results published to date, it is concluded that rituximab, together with other B cell-directed therapies currently under clinical development, is likely to provide an important new treatment option for a number of these diYcult-to-treat autoimmune disorders.

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Long-term remission in a patient with refractory thrombotic thrombocytopenic purpura treated with rituximab and plasma exchange

et al. 2007

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A dramatic response to rituximab in a patient with resistant thrombotic thrombocytopenic purpura (TTP) who developed acute stroke

Abstract: This report suggests that rituximab can provide a good outcome of the dramatic central nervous system involvement in patients with thrombotic thrombocytopenic purpura.

Cited by 7 publications

References 14 publications

Rituximab in the treatment of autoimmune haematological disorders

Rituximab in the treatment of autoimmune haematological disorders

The potential utility of B cell-directed biologic therapy in autoimmune diseases

Long-term remission in a patient with refractory thrombotic thrombocytopenic purpura treated with rituximab and plasma exchange

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