Successful treatment of thrombotic microangiopathy after haematopoietic stem cell transplantation with rituximab.
Thrombotic microangiopathy (TMA) is a grave complication after haematopoietic stem cell transplantation (HSCT) and effective treatment is undefined. Five patients with postHSCT TMA, which was refractory to at least 1 week of plasma exchange and prednisolone, were treated with rituximab (375 mg/m(2)/week x 4). Remission was achieved in four patients, of whom three remained in remission and one had died of sepsis at a median follow-up of 10 months. ADAMTS13 levels were low in all evaluable patients, and only one patient showed significant anti-ADAMTS13 antibody. The levels of ADAMTS13 and anti-ADAMTS13 antibody did not change significantly with rituximab-induced remission.
Au
Wing-Yan
WY
Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China.
Ma
Edmond S
ES
Lee
Tsz-Leung
TL
Ha
Shau-Yin
SY
Fung
Alvin T
AT
Lie
Albert K W
AK
Kwong
Yok-Lam
YL
D051722:ADAM Proteins / Q000276:immunology; D000071120:ADAMTS13 Protein; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D001324:Autoantigens / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D010951:Plasma Exchange; D011239:Prednisolone / Q000627:therapeutic use; D012074:Remission Induction; D012189:Retrospective Studies; D000069283:Rituximab; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D001324:Autoantigens; D015415:Biomarkers; D005938:Glucocorticoids; D007155:Immunologic Factors; D000069283:Rituximab; D011239:Prednisolone; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human