Voravit Ratanatharathorn, MD; Erik Carson, MD; Christopher Reynolds, MD; Lois J. Ayash, MD; John Levine, MD; Gregory Yanik, MD; Samuel M. Silver, MD, PhD; James L.M. Ferrara, MD; Joseph P. Uberti, MD, PhD
Autoimmune thrombocytopenia in chronic graft-versus-host disease may represent an instance of B-cell dysregulation leading to clinical disease.
To attempt to treat refractory immune-mediated thrombocytopenia in a patient with chronic graft-versus-host disease by using anti-CD20 chimeric monoclonal antibody.
Academic medical center.
A patient with chronic graft-versus-host disease after allogeneic peripheral blood stem-cell transplantation who had severe refractory immune-mediated thrombocytopenia.
Weekly infusion of rituximab, 375 mg/m2, for 4 weeks.
Platelet count, CD3+ cell count, and CD19+ cell count.
Rituximab therapy resulted in marked depletion of B cells in the peripheral blood and decreased levels of platelet-associated antibody. The increase in platelet count persisted despite tapering and discontinuation of immunosuppressive therapy for chronic graft-versus-host disease.
The efficacy of rituximab for the treatment of immune-mediated thrombocytopenia suggests that this drug may have activity in other autoimmune diseases or chronic graft-versus-host disease.
Ratanatharathorn V, Carson E, Reynolds C, Ayash LJ, Levine J, Yanik G, et al. Anti-CD20 Chimeric Monoclonal Antibody Treatment of Refractory Immune-Mediated Thrombocytopenia in a Patient with Chronic Graft-versus-Host Disease. Ann Intern Med. ;133:275–279. doi: 10.7326/0003-4819-133-4-200008150-00011
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Published: Ann Intern Med. 2000;133(4):275-279.
Hematology/Oncology, Platelet Disorders.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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