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Eur J Intern Med. 2015 Nov;26(9):659-65. doi: 10.1016/j.ejim.2015.07.021. Epub 2015 Aug 17.

Rituximab in autoimmune thrombotic thrombocytopenic purpura: A success story.

Author information

1
Service de médecine interne, CHI, Créteil, France; Centre de Référence des Microangiopathies Thrombotiques, AP-HP, Paris, France.
2
Centre de Référence des Microangiopathies Thrombotiques, AP-HP, Paris, France; Service d'hématologie biologique, Hôpital Lariboisière, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
3
Service de Médecine Interne, Hôpital la Pitié-Salpétrière, Paris, France.
4
Centre de Référence des Microangiopathies Thrombotiques, AP-HP, Paris, France; Service de médecine interne, CHU Charles Nicolle, Rouen, France.
5
Centre de Référence des Microangiopathies Thrombotiques, AP-HP, Paris, France; Service d'hématologie, Hôpital Saint Antoine, Paris, France; Inserm U1009, Institut Gustave Roussy, Villejuif, France. Electronic address: paul.coppo@aphp.fr.

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?

KEYWORDS:

ADAMTS13; Immunotherapy; Rituximab; Thrombotic thrombocytopenic purpura

PMID:
26293834
DOI:
10.1016/j.ejim.2015.07.021
[Indexed for MEDLINE]
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