Successful Use of Intravenous Immunoglobulins in an Obinutuzumab-related Acute Thrombocytopenia

Haage, Tobias Ronny; Surov, Alexey; Mougiakakos, Dimitrios; Berisha, Mirjeta

doi:10.1097/hs9.0000000000000751

Cited by 5 publications

(12 citation statements)

References 13 publications

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“…To date, only three cases of OIAT have been reported in the literature [8][9][10] (Table 1). Walter et al reported the case of a CLL patient who experienced acute thrombocytopenia and disseminate intravascular coagulopathy after an infusion of 100 mg of obinutuzumab.…”

Section: Discussionmentioning

confidence: 99%

“…Platelet count recovered to normal after a few days. 9 Although OIAT seems to occur mostly during the first cycle, Sakai et al 10 reported a case of OIAT during maintenance therapy with obinutuzumab in a 64-year-old female. This patient was treated with obinutuzumab monotherapy for a relapsed FL.…”

Section: Discussionmentioning

confidence: 99%

“…Haage et al switched from obinutuzumab to rituximab without any recurrence of thrombocytopenia suggesting that there was no cross-toxicity on platelets between the two anti-CD20 antibodies. 9 Our patients were both re-challenged with anti-CD20 monoclonal antibodies. The first one was treated with rituximab, without complication.…”

Section: Rechallengementioning

confidence: 95%

“…Intravenous immunoglobulins may also play a role in platelet recovery. 9 Finally, we report the use of TPO-RA. This treatment, along with steroids, was accompanied by a rise in platelet count.…”

Section: Managementmentioning

confidence: 99%

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Obinutuzumab‐induced acute thrombocytopenia: Report of two cases and review of literature

et al. 2023

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Obinutuzumab is a humanized anti-CD20 monoclonal antibody commonly used in the treatment of non-Hodgkin lymphoma and chronic lymphocytic leukaemia (CLL). In follicular lymphoma (FL) and CLL, obinutuzumab demonstrated superior efficacy compared to rituximab, however at the cost of increased toxicity. 1,2 Among the side effects of obinutuzumab, the Summary of Product Characteristics (SPC) mentions 'severe and lifethreatening thrombocytopenia including acute thrombocytopenia (occurring within 24 h after the infusion)'. 3 However, obinutuzumab-induced acute thrombocytopenia (OIAT) has been rarely reported. Furthermore, the management of OIAT is challenging because of the lack of specific guidelines.Here, we report the case of two patients who experienced acute and severe thrombocytopenia after obinutuzumab infusion. We also performed a review of the literature about this rare but life-threatening side effect. Using PubMed®, we searched for articles published between 2015 and 2023 containing the words 'obinutuzumab', 'thrombocytopenia', 'severe', 'acute', 'lymphoma' or 'leukemia'.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Rechallengementioning

confidence: 95%

Section: Managementmentioning

confidence: 99%

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Obinutuzumab‐induced acute thrombocytopenia: Report of two cases and review of literature

et al. 2023

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“…The optimal management of obinutuzumab‐induced thrombocytopenia is unclear, as the cause is often unclear. Analogous to ITP, steroids and IVIg have been associated with responses whereas platelet transfusions may not be effective 2,5 . Two recent cases of severe thrombocytopenia were treated with thrombopoietin receptor agonist 6 .…”

Section: Discussionmentioning

confidence: 99%

Frequency and outcomes of obinutuzumab‐induced thrombocytopenia

Ng,

Joshi,

Choi

2023

Br J Haematol

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SummaryObinutuzumab is a third‐generation anti‐CD20 monoclonal antibody widely used in the treatment of B‐lymphoproliferative disorders but infrequently associated with severe thrombocytopenia, which can be life‐threatening. The pathophysiology is unclear, but platelet clearance can be extremely rapid (usually within 24 h). In a retrospective case series, we have identified four cases among 149 recipients of obinutuzumab‐containing chemotherapy regimens between 2015 and 2022 treated for haematological malignancies in Canberra, Australia (frequency 2.7%). We illustrate four cases of obinutuzumab‐induced thrombocytopenia with a review of the literature. Research is required to identify the pathophysiology and improve early recognition and management of the condition in the context of multiagent chemotherapy.

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Obinutuzumab

2024

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Successful Use of Intravenous Immunoglobulins in an Obinutuzumab-related Acute Thrombocytopenia

Cited by 5 publications

References 13 publications

Obinutuzumab‐induced acute thrombocytopenia: Report of two cases and review of literature

Obinutuzumab‐induced acute thrombocytopenia: Report of two cases and review of literature

Frequency and outcomes of obinutuzumab‐induced thrombocytopenia

Obinutuzumab

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