Bispecific antibody stops life-threatening combination of ITP and APS
An interdisciplinary team from the Medical Clinic and Polyclinic III at the LMU Klinikum München has successfully treated a young patient with severe, therapy-resistant immune thrombocytopenia (ITP) and antiphospholipid syndrome (APS) with the bispecific antibody blinatumomab for the first time. The novel immunotherapy led to the complete disappearance of the disease-causing autoantibodies, stabilized platelet counts and normalized coagulation activity. The results were published in the “New England Journal of Medicine”.
In the rare coincidence of ITP and APS, the immune system attacks its own platelets and at the same time triggers a pathological tendency to clot. Those affected are therefore acutely endangered, both through severe bleeding and life-threatening thrombosis. Conventional therapies often reach their limits in refractory courses.
The Munich team relied on blinatumomab, a bispecific antibody that specifically binds T cells to disease-causing B cells and eliminates them. As part of a compassionate use program, the patient received two treatment cycles. Shortly after the start of therapy, the platelet counts increased significantly, and the autoantibodies against platelets and phospholipids disappeared completely. Accompanying laboratory tests showed a normalization of the formation of coagulation-promoting platelet aggregates.
Since the treatment, the patient has stable platelet levels, is free of bleeding and thrombosis and was able to start oral anticoagulation for the first time in years. The previously necessary daily subcutaneous injections were eliminated, which led to a significant gain in quality of life.
The hematologists and immunotherapists at the LMU Hospital see bispecific antibodies as a promising, gentler alternative to complex CAR-T cell therapies, which require chemotherapy preparation and are associated with risks such as infertility or secondary tumors. The observation shows the potential of targeted immunotherapies for complex autoimmune diseases, especially in young patients.
Immune thrombocytopenia (ITP) leads to a greatly reduced platelet count and an increased tendency to bleed due to autoantibodies against platelets. Antiphospholipid syndrome (APS) is characterized by autoantibodies against phospholipids or associated proteins that cause an increased risk of thrombosis and pregnancy complications. The simultaneous manifestation of both diseases is an extremely rare and highly dangerous constellation.
Original Paper:
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Editor: X-Press Journalistenbüro GbR
Gender Notice. The personal designations used in this text always refer equally to female, male and diverse persons. Double/triple naming and gendered designations are used for better readability. ected.
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