Combination regimens containing daratumumab for initial diagnosed acquired thrombotic thrombocytopenic purpura

Bortezomib in relapsed/refractory immune thrombotic thrombocytopenic purpura: A single‐centre retrospective cohort and systematic literature review

“…While this case series and literature review demonstrate a robust response of 85% in refractory and recurrent iTTP with bortezomib, it is susceptible to reporting bias, as complete and partial remissions are more likely to be published. Additionally, we did not examine more recent usage of anti-CD38 antibodies, [37][38][39] and it remains an open question which therapy is more effective. It would be useful to study bortezomib in patients with refractory iTTP in a randomized controlled trial where PLEX, corticosteroids and rituximab have failed, especially because the un-protocolized close administration of rituximab and bortezomib in many of these reports makes it difficult to discern the treatment effect.…”

Daratumumab for refractory immune‐mediated thrombotic thrombocytopenic purpura

“…Xie et al 13 have recently published a case series of daratumumab used as part of initial combination treatment. In all three patients, clinical remission was achieved.…”

Plasma cell‐directed therapy strategies in immune‐mediated thrombotic thrombocytopenic purpura (iTTP)

“…Therefore, the idea of targeting plasma cells that produce ADAMTS13 antibodies has emerged to reduce the risk of refractory or relapsing iTTP. 13 The FDA approved caplacizumab as an initial treatment for adult patients with iTTP, in combination with TPE and immunosuppressive treatment. 14,15 Caplacizumab accelerates the normalization time of platelet counts, reduces the number of TPE sessions, and shortens the duration of hospital stay.…”

“…18 In addition to the aforementioned study, daratumumab was added to TPE, corticosteroid, and rituximab combination in a case series. 13 Until August 1, 2022, the median follow-up time for all patients with a clinical response was 7.3 months. Also, clinical remission is defined as "Clinical response after cessation of plasma exchange and maintained for greater than 30 days".…”

“…However, while reducing mortality and achieving remission remain the primary focus of the initial treatment, sustaining remission and preventing relapse pose the main challenges in the long‐term management of iTTP. Therefore, the idea of targeting plasma cells that produce ADAMTS13 antibodies has emerged to reduce the risk of refractory or relapsing iTTP 13 …”