A Canadian phase II study evaluating the efficacy of rituximab in the management of patients with relapsed/refractory thrombotic thrombocytopenic purpura.
Rituximab is a chimeric monoclonal antibody that targets the human CD-20 antigen present on malignant and normal B lymphocytes. Recent clinical studies have shown a significant response rate when this drug is given to selected patients with thrombotic thrombocytopenic purpura (TTP). Given that the clinical manifestations of TTP may be the direct result of an auto-antibody against a regulatory Von Willebrand factor enzyme (ADAMTS13), it makes biological sense to consider a therapy that has the ability to diminish or eradicate antibody-producing B cells. Despite initial positive results, there is a need to identify which patients derive durable benefit from this agent. As in other conditions that utilize therapeutic immunosuppression, there is a risk that the addition of rituximab may also lead to serious opportunistic infections.
Foley
Stephen R
SR
Department of Pathology and Molecular Medicine, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada. foleyr@hhsc.ca
Webert
Kathryn
K
Arnold
Donald M
DM
Rock
Gail A
GA
Clark
William F
WF
Barth
David
D
Sutton
David M
DM
D051722:ADAM Proteins / Q000276:immunology; D000071120:ADAMTS13 Protein; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D001323:Autoantibodies / Q000097:blood; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D002170:Canada; D017322:Clinical Trials, Phase II as Topic; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018579:Patient Selection; D010951:Plasma Exchange; D011697:Purpura, Thrombotic Thrombocytopenic / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D012008:Recurrence; D018570:Risk Assessment; D000069283:Rituximab; D017211:Treatment Failure; D014841:von Willebrand Factor / Q000378:metabolism
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D001323:Autoantibodies; D007166:Immunosuppressive Agents; D014841:von Willebrand Factor; D000069283:Rituximab; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human