Daratumumab and Romiplostim Combined Therapy for a Long-Standing Refractory Primary Immune Thrombocytopenia - Case Report.

IF 6.2 Q1 IMMUNOLOGY
ImmunoTargets and Therapy Pub Date : 2025-01-06 eCollection Date: 2025-01-01 DOI:10.2147/ITT.S487895
Ibrahim Zoubi, Amir Warwar, Shoshan Perek, Meir Preis
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引用次数: 0

Abstract

Multi-refractory immune thrombocytopenia (ITP) is not uncommon and associated with high morbidity and mortality rates. Although the precise mechanism of ITP is not yet fully understood, a therapeutic approach that relies on using a single agent in each treatment line may not be sufficient in this population. We report the case of a 67-year-old female with long-standing multi-refractory ITP treated with a combination of Daratumumab and Romiplostim who achieved a durable response for more than 42 weeks. Owing to the presentation of chronic and refractory disease, we used a dual-agent approach to address early immune destruction and promote megakaryocyte platelet production. Three doses of Daratumumab were administered during the induction phase (weeks 0,1,5) and then at less frequent intervals - every 4-12 weeks for total of 4 doses during the maintenance phase. Romiplostim was administered weekly, with dose modification depending on the platelet count. We hypothesize that when combined with thrombopoietin receptor agonists (TPO-RAs), daratumumab administered at less frequent intervals over an extended period can be safely used, resulting in a prolonged response.

Daratumumab和Romiplostim联合治疗长期难治性原发性免疫性血小板减少症病例报告。
多重难治性免疫性血小板减少症(ITP)并不罕见,发病率和死亡率都很高。虽然ITP的确切机制尚不完全清楚,但依赖于每条治疗线使用单一药物的治疗方法在这一人群中可能还不够。我们报告了一位67岁的长期难治性ITP的女性患者,该患者接受了Daratumumab和Romiplostim联合治疗,获得了超过42周的持续缓解。由于慢性和难治性疾病的出现,我们使用双药方法来解决早期免疫破坏和促进巨核细胞血小板产生。在诱导阶段(第0、1、5周)给予三剂Daratumumab,然后在较不频繁的间隔-在维持阶段每4-12周给予总共4剂。Romiplostim每周给药,剂量根据血小板计数调整。我们假设,当与血小板生成素受体激动剂(TPO-RAs)联合使用时,daratumumab在较短的间隔时间内可以安全地使用,从而延长反应时间。
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来源期刊
CiteScore
16.50
自引率
0.00%
发文量
7
审稿时长
16 weeks
期刊介绍: Immuno Targets and Therapy is an international, peer-reviewed open access journal focusing on the immunological basis of diseases, potential targets for immune based therapy and treatment protocols employed to improve patient management. Basic immunology and physiology of the immune system in health, and disease will be also covered.In addition, the journal will focus on the impact of management programs and new therapeutic agents and protocols on patient perspectives such as quality of life, adherence and satisfaction.
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