Article Dans Une Revue British Journal of Haematology Année : 2024

Efficacy and safety of daratumumab in multiresistant immune‐mediated thrombotic thrombocytopenic purpura

Résumé

The immunosuppressive treatment of immune-mediated thrombotic thrombocytopenic purpura (iTTP) in patients with intolerance or refractoriness to the B-cell depleting monoclonal antibody rituximab remains debated. Daratumumab, a plasma cell-directed monoclonal antibody targeting CD38, represents a therapeutic option, but data are scarce. The French Thrombotic Microangiopathies Reference Center conducted a nationwide survey on iTTP patients treated with daratumumab. Nine episodes from seven patients were identified. Treatment was administered for A Disintegrin And Metalloproteinase with ThromboSpondin-1 motifs, 13th member (ADAMTS13) relapses while patients were otherwise in clinical response (N = 8), or during the acute phase of the disease following rituximab intolerance (N = 1). Patients have received a median of three previous therapeutic lines. ADAMTS13 activity improved in eight cases following daratumumab administration, including three cases where ADAMTS13 normalized. ADAMTS13 relapses occurred in three patients; in two cases, retreatment with daratumumab was successful. Median ADAMTS13 relapse-free survival was not reached; 12-month ADAMTS13 relapsefree survival was 56%. Daratumumab-related adverse events occurred in five cases and were non-severe infusion-related reactions in all cases. These results suggest that daratumumab may be an effective treatment option for iTTP patients with intolerance or refractoriness to rituximab.

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hal-04952748 , version 1 (17-02-2025)

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Julia Weisinger, Raïda Bouzid, Dana Ranta, Pascal Woaye-Hune, Fleur Cohen-Aubart, et al.. Efficacy and safety of daratumumab in multiresistant immune‐mediated thrombotic thrombocytopenic purpura. British Journal of Haematology, 2024, 205 (5), pp.1951 - 1958. ⟨10.1111/bjh.19752⟩. ⟨hal-04952748⟩
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