Immune thrombotic thrombocytopenic purpura treated with Obinutuzumab: a case report and literature review
10.3760/cma.j.cn121090-20241123-00474
- VernacularTitle:奥妥珠单抗治疗免疫性血栓性血小板减少性紫癜1例报告并文献复习
- Author:
Xiaotong CHEN
1
;
Yanqiu ZHAO
1
;
Qi LI
1
;
Haitao LI
1
;
Dandan LI
1
;
Qian ZHANG
1
;
Jinyue FU
1
;
Dongxue LU
1
;
Dongyang ZHANG
1
;
Shengjin FAN
1
Author Information
1. 哈尔滨医科大学附属第一医院血液科，哈尔滨 150070
- Publication Type:Journal Article
- Keywords:
Immune thrombotic thrombocytopenic purpura;
Obinutuzumab;
ADAMTS13
- From:
Chinese Journal of Hematology
2024;45(S1):53-56
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the safety and efficacy of Obinutuzumab in the treatment of immune thrombotic thrombocytopenic purpura.Methods:Data from a case of immune thrombotic thrombocytopenic purpura (iTTP) admitted to the Department of haematology of the First Affiliated Hospital of Harbin Medical University were evaluated retrospectively and a literature review was performed.Results:A 66-year-old female patient was admitted to our hospital for thrombocytopenia. On admission, physical examination showed that yellow skin and sclera. The patient was fully conscious but had a decreasing ability to calculate. Laboratory examination revealed a platelet count of 7×10 9/L; liver function: alanine aminotransferase 55.2 U/L, azelaic aminotransferase 117.5 U/L; total bilirubin 142.7 μmol/L, direct bilirubin 64.6 μmol/L, indirect bilirubin 78.1 μmol/L; lactate dehydrogenase: 2362 U/L; creatinine: 260.7 μmol/L; peripheral blood smear showed 4% fragmented erythrocytes; ADAMTS13 activity 2.7% and positive inhibitor (1.12 BU). The patient is treated with plasma exchange and glucocorticoids, but the patient’s symptoms worsened. Rituximab was permanently discontinued for severe infusion reactions. Treatment with Obinutuzumab (1000 mg, qw×2 w) and she achieved a complete remission for 18 months. The treatment was well tolerated with no adverse events related to Obinutuzumab. Conclusion:For iTTP patients with rituximab intolerance, obinutuzumab is a safe and effective alternative treatment option.
