Efficacy of Rituximab in the Treatment of Plasma Exchange Refractory Thrombotic Thrombocytopenic Purpura

Rituximab can induce a durable remission in plasma exchange refractory thrombotic thrombocytopenic purpura (TTP). Timing of Rituximab infusion in combination with plasma exchange (PE) and long term follow-up for probable side effects of such treatment is still lacking. This study was conducted among 10 patients with plasma exchange refractory TTP. According to the study designation, first PE was performed within 36-48 hours after first dose of rituximab. Eight of ten (80%) patients received 1 course of rituximab. Two of ten (20%) patients received another course of rituximab due to relapse. Repsonse rate (RR) to rituximab in combination with plasma exchange, was 90%. Overall Survival of the patients was 90% and 1 and 5-year relapse free survival rate (RFS) was 90% and 83%, respectively. One of the patients expired due to Systemic Lupus Erythematosus flare up. According to this study, treatment of refractory TTP with rituximab in combination with PE could be effective.
Iranian Registry of Clinical Trials: IRCT2017012232125N1