Rituximab for managing refractory thrombotic thrombocytopenic purpura: a report of three cases

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  • YAMANOUCHI Jun
    Ehime University Graduate School of Medicine, Department of Bioregulatory Medicine
  • HATO Takaaki
    Ehime University Graduate School of Medicine, Department of Bioregulatory Medicine
  • MIYOSHI Kazuhiro
    Ehime University Graduate School of Medicine, Department of Bioregulatory Medicine
  • KOBAYASHI Shinji
    Ehime University Graduate School of Medicine, Department of Bioregulatory Medicine
  • AZUMA Taichi
    Ehime University Graduate School of Medicine, Department of Bioregulatory Medicine
  • HASEGAWA Hitoshi
    Ehime University Graduate School of Medicine, Department of Bioregulatory Medicine
  • YASUKAWA Masaki
    Ehime University Graduate School of Medicine, Department of Bioregulatory Medicine

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Other Title
  • rituximabを投与した難治性血栓性血小板減少性紫斑病の3症例
  • rituximab オ トウヨ シタ ナンチセイ ケッセンセイ ケッショウバン ゲンショウセイ シハンビョウ ノ 3 ショウレイ

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Abstract

About 20% of TTP are resistant to plasma exchange. As reported in a few case reports and small case series, rituximab has been used in the treatment of TTP with some benefit. However, the optimal dosing, frequency, and timing of rituximab remain to be determined. We treated three cases of refractory TTP with rituximab. Case 1 exhibited brain sequelae probably due to the late administration of rituximab, case 2 died before the expected effect of rituximab could occur, and case 3 recovered completely because of the early administration of rituximab. These results suggest that rituximab should be given as early as possible in TTP, but large clinical studies are required to determine the optimal use of rituximab in TTP.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 54 (2), 205-209, 2013

    The Japanese Society of Hematology

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