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Case Reports
. 2011 Mar;46(1):45-8.
doi: 10.5045/kjh.2011.46.1.45. Epub 2011 Mar 15.

Slow, but complete, resolution of mitomycin-induced refractory thrombotic thrombocytopenic purpura after rituximab treatment

Mi Jin Hong  1 , Hong Ghi Lee, Mina Hur, Sung Yong Kim, Yo Han Cho, So Young Yoon
Affiliations
Case Reports

Slow, but complete, resolution of mitomycin-induced refractory thrombotic thrombocytopenic purpura after rituximab treatment

Mi Jin Hong et al. Korean J Hematol. 2011 Mar.

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a critical complication of treatment with mitomycin C. We retrospectively describe the case of a patient with progressive renal cell carcinoma and mitomycin-induced TTP refractory to plasma exchange and glucocorticoids; we describe the clinical course, successful management of TTP with rituximab, and follow-up of this case. Mitomycin-induced TTP resolved completely by a total of 4 infusions of rituximab 375 mg/m(2) on a weekly basis, and it took up to 12 months to obtain a platelet count of >100,000/µL. Rituximab is indicated for the treatment of mitomycin-induced TTP refractory to plasma exchange and glucocorticoids, and it could improve the patient's quality of life despite the presence of underlying malignancy.

Keywords: Mitomycin; Plasma exchange; Rituximab; Thrombotic thrombocytopenic purpura.

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Figures

Fig. 1
Fig. 1
Peripheral blood smear (Wright stain, ×1,000) showing schistocytes and spherocytes.
Fig. 2
Fig. 2
Change of platelet and schistocyte count during the treatment period.
See this image and copyright information in PMC

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