Daratumumab and Romiplostim Combined Therapy for a Long-Standing Refractory Primary Immune Thrombocytopenia – Case Report
Ibrahim Zoubi,1 Amir Warwar,1,2 Shoshan Perek,1 Meir Preis1,2 1Institute of Hematology, Lady Davis Carmel Medical Center, Haifa, Israel; 2Bruce and Ruth Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, IsraelCorrespondence: Meir Preis, Institute of Hematology, Lady Dav...
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Dove Medical Press
2025-01-01
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| author | Zoubi I Warwar A Perek S Preis M |
| author_facet | Zoubi I Warwar A Perek S Preis M |
| author_sort | Zoubi I |
| collection | DOAJ |
| description | Ibrahim Zoubi,1 Amir Warwar,1,2 Shoshan Perek,1 Meir Preis1,2 1Institute of Hematology, Lady Davis Carmel Medical Center, Haifa, Israel; 2Bruce and Ruth Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, IsraelCorrespondence: Meir Preis, Institute of Hematology, Lady Davis Carmel Medical Center, 7 Michal St, Haifa, Israel, Tel +972-4-8250445, Email Meirpr@clalit.org.ilAbstract: 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.Keywords: multi-refractory immune thrombocytopenia, anti CD38 directed therapy, TPO mimetic agents, case report |
| format | Article |
| id | doaj-art-d1637a6ab5264c04b6a96da470d3ed14 |
| institution | Kabale University |
| issn | 2253-1556 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | ImmunoTargets and Therapy |
| spelling | doaj-art-d1637a6ab5264c04b6a96da470d3ed142025-01-07T16:42:40ZengDove Medical PressImmunoTargets and Therapy2253-15562025-01-01Volume 141598969Daratumumab and Romiplostim Combined Therapy for a Long-Standing Refractory Primary Immune Thrombocytopenia – Case ReportZoubi IWarwar APerek SPreis MIbrahim Zoubi,1 Amir Warwar,1,2 Shoshan Perek,1 Meir Preis1,2 1Institute of Hematology, Lady Davis Carmel Medical Center, Haifa, Israel; 2Bruce and Ruth Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, IsraelCorrespondence: Meir Preis, Institute of Hematology, Lady Davis Carmel Medical Center, 7 Michal St, Haifa, Israel, Tel +972-4-8250445, Email Meirpr@clalit.org.ilAbstract: 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.Keywords: multi-refractory immune thrombocytopenia, anti CD38 directed therapy, TPO mimetic agents, case reporthttps://www.dovepress.com/daratumumab-and-romiplostim-combined-therapy-for-a-long-standing-refra-peer-reviewed-fulltext-article-ITTmulti-refractory immune thrombocytopeniaanti cd38 directed therapytpo mimetic agentscase report |
| spellingShingle | Zoubi I Warwar A Perek S Preis M Daratumumab and Romiplostim Combined Therapy for a Long-Standing Refractory Primary Immune Thrombocytopenia – Case Report ImmunoTargets and Therapy multi-refractory immune thrombocytopenia anti cd38 directed therapy tpo mimetic agents case report |
| title | Daratumumab and Romiplostim Combined Therapy for a Long-Standing Refractory Primary Immune Thrombocytopenia – Case Report |
| title_full | Daratumumab and Romiplostim Combined Therapy for a Long-Standing Refractory Primary Immune Thrombocytopenia – Case Report |
| title_fullStr | Daratumumab and Romiplostim Combined Therapy for a Long-Standing Refractory Primary Immune Thrombocytopenia – Case Report |
| title_full_unstemmed | Daratumumab and Romiplostim Combined Therapy for a Long-Standing Refractory Primary Immune Thrombocytopenia – Case Report |
| title_short | Daratumumab and Romiplostim Combined Therapy for a Long-Standing Refractory Primary Immune Thrombocytopenia – Case Report |
| title_sort | daratumumab and romiplostim combined therapy for a long standing refractory primary immune thrombocytopenia ndash case report |
| topic | multi-refractory immune thrombocytopenia anti cd38 directed therapy tpo mimetic agents case report |
| url | https://www.dovepress.com/daratumumab-and-romiplostim-combined-therapy-for-a-long-standing-refra-peer-reviewed-fulltext-article-ITT |
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