The many facets of immune-mediated thrombocytopenia: Principles of immunobiology and immunotherapy.
Fiche publication
Date publication
janvier 2024
Journal
Blood reviews
Auteurs
Membres identifiés du Cancéropôle Est :
Dr PAGLIUCA Simona
Tous les auteurs :
Moulinet T, Moussu A, Pierson L, Pagliuca S
Lien Pubmed
Résumé
Immune thrombocytopenia (ITP) is a rare autoimmune condition, due to peripheral platelet destruction through antibody-dependent cellular phagocytosis, complement-dependent cytotoxicity, cytotoxic T lymphocyte-mediated cytotoxicity, and megakaryopoiesis alteration. This condition may be idiopathic or triggered by drugs, vaccines, infections, cancers, autoimmune disorders and systemic diseases. Recent advances in our understanding of ITP immunobiology support the idea that other forms of thrombocytopenia, for instance, occurring after immunotherapy or cellular therapies, may share a common pathophysiology with possible therapeutic implications. If a decent pipeline of old and new agents is currently deployed for classical ITP, in other more complex immune-mediated thrombocytopenic disorders, clinical management is less harmonized and would deserve further prospective investigations. Here, we seek to provide a fresh overview of pathophysiology and current therapeutical algorithms for adult patients affected by this disorder with specific insights into poorly codified scenarios, including refractory ITP and post-immunotherapy/cellular therapy immune-mediated thrombocytopenia.
Mots clés
Allogeneic hematopoietic cell transplantation, Autoimmunity, CAR-T cells, Cellular therapies, ITP, Immunotherapy, Primary and secondary ITP, Thrombocytopenia
Référence
Blood Rev. 2024 01;63:101141