Rituximab in autoimmune thrombotic thrombocytopenic purpura: A success story

Abstract

Despite a significant improvement of thrombotic thrombocytopenic purpura (TTP) prognosis since the use of plasma exchange, morbidity and mortality remained significant because of poor response to standard treatment or exacerbations and relapses. Rituximab, a chimeric monoclonal antibody directed against the B-lymphocyte CD20 antigen, has shown a particular interest in this indication. Recent studies also reported strong evidence for its efficiency in the prevention of relapses. This review addresses these recent progresses and still opened questions in this topic: should rituximab be proposed in all patients at the acute phase? Should all patients benefit from a preemptive treatment? Is the infectious risk acceptable in this context?

How we treat thrombotic thrombocytopenic purpura: Results of a Canadian TTP practice survey

“…The CAG and non‐CAG physicians both reported using it more frequently in refractory cases than in relapsed disease. Rituximab use in both of these clinical situations is supported by multiple case reports, case series, and single‐arm trials, and these are approved indications for use in Canada. Though one CAG member reported experience with upfront rituximab, it is not usually available for this indication.…”

Rituximab reduces risk for relapse in patients with thrombotic thrombocytopenic purpura

“…CSF3R mutations have a high degree of overlap with CEBPA mutations in pediatric AML Julia E. Maxson, 1 Rhonda E. Ries, 1 Yi-Cheng Wang, 2 Robert B. Gerbing, 2 E. Anders Kolb, 3 Sarah L. Thompson, 1 Jaime M. Guidry Auvil, 4 Marco A. Marra, 5 Yussanne Ma, 5 Zusheng Zong, 5 Andrew J. Mungall, 5 Richard Moore, 5 William Long, 5 Patee Gesuwan, 4 Tanja M. Davidsen, 4 Leandro C. Hermida, 4 Seamus B. Hughes, 1 Jason E. Farrar, 6 Jerald P. Radich, 1 Childhood cancers represent distinct clinical entities, often with unique genomic alterations and therapeutic responses that differ from cancers arising in adults. Pediatric acute myeloid leukemia (AML) comprises ;25% of childhood leukemias.…”

Efficacy of rituximab and plasmapharesis in an adult patient with antifactor H autoantibody-associated hemolytic uremic syndrome

“…[19] Thus, the main mechanism of action of RTX could be the depletion of B cells leading to short-lived plasmocytes that secrete anti-CFHAb (lifespan 10–20 days). [20] This would explain why the action of rituximab occurred after 10 to 21 days. [21] Cyclophosphamide targets on all cell lines producing antibodies (LcB, LcT, and plamocytes).…”