Imlifidase Utilization in Glanzmann Thrombasthenia with Anti-GPIIb/IIIa
and Anti-HLA Alloimmunization and Severe Platelet Refractoriness
following Hematopoietic Stem Cell Transplant.
Abstract
Glanzmann Thrombasthenia (GT) is an inherited bleeding disorder of poor
platelet function secondary to a defect in platelet membrane
glycoprotein IIb/IIIa (GPIIb/IIIa). Patients with GT may develop
anti-platelet antibodies including anti-GPIIb/IIIa which can lead to
severe refractory thrombocytopenia and life-threatening bleeding,
management of which is challenging. We report successful use of
imlifidase, a novel IgG protease enzyme, as part of a multimodal
approach for management of severe platelet refractoriness and
alloimmunization in a child with GT and primary graft failure following
hematopoietic stem cell transplant (HSCT). The patient had no detectable
anti-platelet alloantibodies following imlifidase, and underwent a
second HSCT.