Korean J Hematol.  2011 Mar;46(1):45-48. 10.5045/kjh.2011.46.1.45.

Slow, but complete, resolution of mitomycin-induced refractory thrombotic thrombocytopenic purpura after rituximab treatment

• Hong MJ
• Lee HG
• Hur M
• Kim SY
• Cho YH
• Yoon SY

• KMID: 2252019
• DOI: http://doi.org/10.5045/kjh.2011.46.1.45

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a critical complication of treatment with mitomycin C. We retrospectively describe the case of a patient with progressive renal cell carcinoma and mitomycin-induced TTP refractory to plasma exchange and glucocorticoids; we describe the clinical course, successful management of TTP with rituximab, and follow-up of this case. Mitomycin-induced TTP resolved completely by a total of 4 infusions of rituximab 375 mg/m2 on a weekly basis, and it took up to 12 months to obtain a platelet count of >100,000/microL. Rituximab is indicated for the treatment of mitomycin-induced TTP refractory to plasma exchange and glucocorticoids, and it could improve the patient's quality of life despite the presence of underlying malignancy.

Keyword

Thrombotic thrombocytopenic purpura; Rituximab; Mitomycin; Plasma exchange

MeSH Terms

Antibodies, Monoclonal, Murine-Derived
Carcinoma, Renal Cell
Follow-Up Studies
Glucocorticoids
Humans
Mitomycin
Plasma Exchange
Platelet Count
Purpura, Thrombotic Thrombocytopenic
Quality of Life
Retrospective Studies
Thymine Nucleotides
Rituximab
Antibodies, Monoclonal, Murine-Derived
Glucocorticoids
Mitomycin
Thymine Nucleotides

Figure

• 

  Fig. 1 Peripheral blood smear (Wright stain, ×1,000) showing schistocytes and spherocytes.

• 

  Fig. 2 Change of platelet and schistocyte count during the treatment period.

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