A Canadian phase II study evaluating the efficacy of rituximab in the management of patients with relapsed/refractory thrombotic thrombocytopenic purpura.

Abstract	Rituximab is a chimeric monoclonal antibody that targets the human CD-20 antigen present on malignant and normal B lymphocytes. Recent clinical studies have shown a significant response rate when this drug is given to selected patients with thrombotic thrombocytopenic purpura (TTP). Given that the clinical manifestations of TTP may be the direct result of an auto-antibody against a regulatory Von Willebrand factor enzyme (ADAMTS13), it makes biological sense to consider a therapy that has the ability to diminish or eradicate antibody-producing B cells. Despite initial positive results, there is a need to identify which patients derive durable benefit from this agent. As in other conditions that utilize therapeutic immunosuppression, there is a risk that the addition of rituximab may also lead to serious opportunistic infections.
Authors	Stephen R Foley, Kathryn Webert, Donald M Arnold, Gail A Rock, William F Clark, David Barth, David M Sutton, Members of the Canada Apheresis Group (CAG)
Journal	Kidney international. Supplement (Kidney Int Suppl) Issue 112 Pg. S55-8 (Feb 2009) ISSN: 0098-6577 [Print] United States
PMID	19180138 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
Chemical References	Antibodies, Monoclonal Antibodies, Monoclonal, Murine-Derived Autoantibodies Immunosuppressive Agents von Willebrand Factor Rituximab ADAM Proteins ADAMTS13 Protein ADAMTS13 protein, human
Topics	ADAM Proteins (immunology) ADAMTS13 Protein Antibodies, Monoclonal (adverse effects, therapeutic use) Antibodies, Monoclonal, Murine-Derived Autoantibodies (blood) B-Lymphocytes (drug effects, immunology) Canada Clinical Trials, Phase II as Topic Humans Immunosuppressive Agents (adverse effects, therapeutic use) Patient Selection Plasma Exchange Purpura, Thrombotic Thrombocytopenic (blood, drug therapy, immunology) Recurrence Risk Assessment Rituximab Treatment Failure von Willebrand Factor (metabolism)

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