Rituximab therapy for thrombotic thrombocytopenic purpura: A proposed study of the transfusion medicine/hemostasis clinical trials network with a systematic review of rituximab therapy for immune-mediated disorders

被引:85
作者
George, JN
Woodson, RD
Kiss, JE
Kojouri, K
Vesely, SK
机构
[1] Univ Oklahoma, Hlth Sci Ctr, Hematol Oncol Sect, Coll Med, Oklahoma City, OK 73190 USA
[2] Univ Oklahoma, Hlth Sci Ctr, Coll Publ Hlth, Dept Biostat & Epidemiol, Oklahoma City, OK 73190 USA
[3] Univ Wisconsin, Sch Med, Dept Med, Sect Hematol, Madison, WI USA
[4] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA
[5] Inst Transfus Med, Pittsburgh, PA USA
关键词
rituximab; thrombotic thrombocytopenic purpura (TTP); systematic review;
D O I
10.1002/jca.20091
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The rationale for immunosuppressive therapy of thrombotic thrombocytopenic purpura (TTP) was established by observations that TTP may be caused by autoantibodies to ADAMTS13. Patients with high-titer autoantibodies to ADAMTS13 may have a higher mortality, and survivors may require prolonged plasma exchange therapy in spite of adjunctive glucocorticoid treatment. More intensive immunosuppressive therapy with rituximab may provide benefit for many of these patients. The Transfusion Medicine/Hemostasis Clinical Trials Network is developing a randomized, clinical trial to test the hypothesis that addition of rituximab to standard treatment of TTP with plasma exchange and glucocorticoids will decrease initial treatment failure rates as well as subsequent relapses over the following 3 years. To provide the background data for this clinical trial, a systematic review of all published reports on rituximab treatment of immune-mediated disorders was performed. Twelve articles have reported 27 patients treated with rituximab for TTP, with benefit described in 25 (93%) of the patients. Additional reports have described rituximab treatment of 37 other immune-mediated disorders, with clinical response in most patients. These observations from small uncontrolled case series provide the background and rationale for a randomized clinical trial to establish the role of rituximab in the management of patients with TTP.
引用
收藏
页码:49 / 56
页数:8
相关论文
共 60 条
[21]   An open study of B lymphocyte depletion in systemic lupus erythematosus [J].
Leandro, MJ ;
Edwards, JC ;
Cambridge, G ;
Ehrenstein, MR ;
Isenberg, DA .
ARTHRITIS AND RHEUMATISM, 2002, 46 (10) :2673-2677
[22]   Clinical outcome in 22 patients with rheumatoid arthritis treated with B lymphocyte depletion [J].
Leandro, MJ ;
Edwards, JCW ;
Cambridge, G .
ANNALS OF THE RHEUMATIC DISEASES, 2002, 61 (10) :883-888
[23]   Rituximab in the treatment of dermatomyositism - An opel-label pilot study [J].
Levine, TD .
ARTHRITIS AND RHEUMATISM, 2005, 52 (02) :601-607
[24]   IgM antibody-related polyneuropathies: B-cell depletion chemotherapy using Rituximab [J].
Levine, TD ;
Pestronk, A .
NEUROLOGY, 1999, 52 (08) :1701-1704
[25]   B cell depletion as a novel treatment for systemic lupus erythematosus - A phase I/II dose-escalation trial of rituximab [J].
Looney, RJ ;
Anolik, JH ;
Campbell, D ;
Felgar, RE ;
Young, F ;
Arend, LJ ;
Sloand, JA ;
Rosenblatt, J ;
Sanz, I .
ARTHRITIS AND RHEUMATISM, 2004, 50 (08) :2580-2589
[26]   Rituximab therapy for HIV-associated Castleman disease [J].
Marcelin, AG ;
Aaron, L ;
Mateus, C ;
Gyan, E ;
Gorin, I ;
Viard, JP ;
Calvez, V ;
Dupin, N .
BLOOD, 2003, 102 (08) :2786-2788
[27]   Mechanisms of disease - Thrombotic microangiopathies [J].
Moake, JL .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 347 (08) :589-600
[28]   A phase II study of Rituximab in rheumatoid arthritis patients with recurrent disease following haematopoietic stem cell transplantation [J].
Moore, J ;
Ma, D ;
Will, R ;
Cannell, P ;
Handel, M ;
Milliken, S .
BONE MARROW TRANSPLANTATION, 2004, 34 (03) :241-247
[29]   Refractory autoimmune thrombocytopenic purpura: Responses to treatment with a recombinant antibody to lymphocyte membrane antigen CD20 (Rituximab) [J].
Narang, M ;
Penner, JA ;
Williams, D .
AMERICAN JOURNAL OF HEMATOLOGY, 2003, 74 (04) :263-267
[30]   Treatment of IgM antibody associated polyneuropathies using rituximab [J].
Pestronk, A ;
Florence, J ;
Miller, T ;
Choksi, R ;
Al-Lozi, MT ;
Levine, TD .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2003, 74 (04) :485-489