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Clinical Trial
. 2019 Sep 26;134(13):1106-1109.
doi: 10.1182/blood.2019000795. Epub 2019 Jul 22.

Adjuvant low-dose rituximab and plasma exchange for acquired TTP

Jeffrey I Zwicker  1 , Joshua Muia  2 , Leili Dolatshahi  3 , Lisa A Westfield  2 , Patricia Nieters  4 , Anita Rodrigues  1 , Ayad Hamdan  1 , Ana G Antun  5 , Ara Metjian  6 , J Evan Sadler  2   7 ; ART Investigators
Affiliations
Clinical Trial

Adjuvant low-dose rituximab and plasma exchange for acquired TTP

Jeffrey I Zwicker et al. Blood. .
No abstract available

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Conflict of interest statement

Conflict-of-interest disclosure: J.I.Z. discloses prior research funding from Quercegen Pharma and Incyte and has served on scientific advisory boards for Portola Pharmaceuticals, Bayer, Pfizer, and Seattle Genetics. J.M. and J.E.S. have a patent, fluorogenic substrate for ADAMTS‐13, US 8663912, issued to Washington University. The remaining authors declare no competing financial interests.

Figures

Figure 1.
Figure 1.
Outcomes following low-dose rituximab and plasma exchange for the treatment of acquired TTP. (A) Time to initial treatment response (ie, platelet count >150 000/mL on 2 consecutive days). (B) The incidence of exacerbation prior to day 30 was 12%. (C) The relapse-free survival at 2 years was 72%. The cumulative incidence of response and relapse was estimated by the method of Kaplan-Meier.
Figure 2.
Figure 2.
Changes in platelets, CD19 lymphocytes, ADAMTS13 activity following initial treatment with weekly rituximab 100 mg and plasma exchange. Box plots of platelet count (A) and absolute CD19+ lymphocyte % (B), and ADAMTS13% activity (C) are shown at time intervals. An Illustrative case of relapse (D) following 4 weekly doses of rituxan 100 mg (labeled rit100) and 4 weekly doses of rituxan 375 mg/m2 (labeled rit375) administered at time of relapse. Serial measurements of platelet count (green) and absolute CD19 lymphocyte count (blue) shown over time with relapse occurring around years 1 and 2. ADAMTS13 activity shown in red. A similar pattern of CD19 lymphocyte count rise and platelet decline observed following both dosing regimens of rituximab.
See this image and copyright information in PMC

References

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    1. Sadler JE. Von Willebrand factor, ADAMTS13, and thrombotic thrombocytopenic purpura. Blood. 2008;112(1):11-18. - PMC - PubMed
    1. Scully M, McDonald V, Cavenagh J, et al. . A phase 2 study of the safety and efficacy of rituximab with plasma exchange in acute acquired thrombotic thrombocytopenic purpura. Blood. 2011;118(7):1746-1753. - PubMed
    1. Westwood JP, Webster H, McGuckin S, McDonald V, Machin SJ, Scully M. Rituximab for thrombotic thrombocytopenic purpura: benefit of early administration during acute episodes and use of prophylaxis to prevent relapse. J Thromb Haemost. 2013;11(3):481-490. - PubMed

Publication types

Supplementary concepts