In the case of immune thrombocytopenia, the immune system is directed against the patient's own blood platelets, resulting in spontaneous bleeding. Antiphospholipid syndrome, on the other hand, leads to pathological activation of coagulation and life-threatening thromboses. If the two diseases come together, a dangerous contradiction arises: the body is at risk of bleeding to death and forming blood clots at the same time. "Such patients present us with extreme medical challenges," explains Prof. Dr. Karsten Spiekermann, hemostaseologist at LMU University Hospital Munich.

As part of a compassionate use program, a young patient with therapy-resistant ITP and APS received two cycles of treatment with blinatumomab. Shortly after starting treatment, the blood platelets increased and the previously disease-causing antibodies disappeared completely. "After countless unsuccessful treatment attempts, we were able to taper off the haematopoietic drugs for the first time - but the platelets remained stable," reports Dr. Adrian Gottschlich, first author of the study. "At the same time, the autoantibodies, which were responsible for both the bleeding tendency and the thromboses, disappeared."

Accompanying laboratory analyses, carried out in cooperation with PD Dr. Rainer Kaiser (Department of Medicine I, Cardiology), also showed that the formation of coagulation-promoting blood platelets completely normalized after the therapy.

Since the treatment, the patient has normal platelet counts and is free of pain, bleeding and thrombosis - and was able to start oral blood-thinning therapy again for the first time in years and avoid daily subcutaneous injections. This means an enormous gain in quality of life and a return to a normal life. "The data show the enormous potential of targeted immunotherapies for autoimmune diseases," emphasizes Prof. Dr. Dr. Michael von Bergwelt. "Bispecific antibodies in particular open up new, safe treatment options - especially for young patients."