{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T02:11:42Z","timestamp":1794622302332,"version":"4.9.1"},"reference-count":9,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Thrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening disorder due to a severe acquired or inherited ADAMTS13 deficiency. So far, therapeutic algorithms almost universally include the prompt initiation of therapeutic plasma exchange (TPE). We firstly report a 55-year-old female with a history of relapsing TTP who was managed exclusively with caplacizumab, steroids and the second generation fully humanized anti-CD20 monoclonal antibody obinutuzumab during a relapse without the need of TPE throughout the whole disease course. This case illustrates the safety and effectiveness of a TPE-free TTP management using prompt initiation of caplacizumab and obinutuzumab.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1588471","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T05:33:35Z","timestamp":1745818415000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Early caplacizumab and obinutuzumab enable successful treatment of relapsing thrombotic thrombocytopenic purpura without therapeutic plasma exchange: a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Judith","family":"Schimpf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Haller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuel","family":"Zitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-10-709857","article-title":"Thrombotic thrombocytopenic purpura","volume":"129","author":"Joly","year":"2017","journal-title":"Blood"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfac034","article-title":"European Renal Best Practice endorsement of guidelines for diagnosis and therapy of thrombotic thrombocytopaenic purpura published by the International Society on Thrombosis and Haemostasis","volume":"37","author":"Eller","year":"2022","journal-title":"Nephrol Dial Transplant"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1806311","article-title":"Caplacizumab treatment for acquired thrombotic thrombocytopenic purpura","volume":"380","author":"Scully","year":"2019","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2010.03761.x","article-title":"ADAMTS-13 assays in thrombotic thrombocytopenic purpura","volume":"8","author":"Peyvandi","year":"2010","journal-title":"J Thromb Haemost"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023023780","article-title":"Management of immune thrombotic thrombocytopenic purpura without therapeutic plasma exchange","volume":"144","author":"Kuhne","year":"2024","journal-title":"Blood"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-03-771832","article-title":"Obinutuzumab: what is there to learn from clinical trials","volume":"130","author":"Cartron","year":"2017","journal-title":"Blood"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1158\/1535-7163.MCT-12-1182","article-title":"Preclinical activity of the type II CD20 antibody GA101 (obinutuzumab) compared with rituximab and ofatumumab in vitro and in xenograft models","volume":"12","author":"Herter","year":"2013","journal-title":"Mol Cancer Ther"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-06-225979","article-title":"Increasing the efficacy of CD20 antibody therapy through the engineering of a new type II anti-CD20 antibody with enhanced direct and immune effector cell-mediated B-cell cytotoxicity","volume":"115","author":"Mossner","year":"2010","journal-title":"Blood"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.v100.2","article-title":"Efficacy and safety of obinutuzumab in immune-mediated thrombotic thrombocytopenic purpura","volume":"100","author":"Weisinger","year":"2025","journal-title":"Am J Hematol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1588471\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T05:33:35Z","timestamp":1745818415000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1588471\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":9,"alternative-id":["10.3389\/fimmu.2025.1588471"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1588471","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,28]]},"article-number":"1588471"}}