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Cancer Chemotherapy and Pharmacology
Published in: Cancer Chemotherapy and Pharmacology 5/2010

01-04-2010 | Short Communication

Rapid and complete resolution of chemotherapy-induced thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) with rituximab

Authors: Brett L. Gourley, Hector Mesa, Pankaj Gupta

Published in: Cancer Chemotherapy and Pharmacology | Issue 5/2010

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Abstract

Purpose

Gemcitabine-induced thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) is a well described, albeit rare, complication, which is associated with a high morbidity and mortality. Treatment with standard TTP/HUS therapies such as plasma exchange, and cessation of gemcitabine is often unsuccessful. The purpose of this report is to describe the successful treatment of gemcitabine-induced TTP/HUS with rituximab, a CD20 monoclonal antibody that has been used for the treatment of refractory idiopathic TTP/HUS.

Methods

We describe the clinical course and follow-up of a patient who developed gemcitabine-induced TTP/HUS, did not respond to cessation of gemcitabine, administration of plasma exchanges, and intravenous glucocorticoids, but responded to rituximab.

Results

TTP/HUS responded rapidly and resolved completely with two courses (8 doses) of intravenous rituximab. In three of four reported cases (including the current report), rituximab was rapidly effective in resolving chemotherapy-induced TTP/HUS that was refractory to plasma exchanges and glucocorticoids.

Conclusions

Rituximab may be indicated for early treatment of chemotherapy-induced TTP/HUS, particularly when plasma exchange is not rapidly effective.
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Metadata
Title
Rapid and complete resolution of chemotherapy-induced thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) with rituximab
Authors
Brett L. Gourley
Hector Mesa
Pankaj Gupta
Publication date
01-04-2010
Publisher
Springer-Verlag
Published in
Cancer Chemotherapy and Pharmacology / Issue 5/2010
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-010-1258-4

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