Oncology Today with Dr Neil Love Immune Thrombocytopenia — Microlearning Activity 1 with Dr Hanny Al-Samkari: ASH 2025 Review
Mar 3, 2026
Dr Hanny Al-Samkari, hematologist and clinical investigator at Massachusetts General Hospital, discusses novel ITP therapies from ASH 2025. He explains yonalimab’s BAFF-R mechanism, dosing, safety and effects on infections and allergies. He also covers rilzabrutinib’s BTK selectivity, LUNA-3 results, dosing challenges, and how these agents might be sequenced in practice.
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Yonalimab Dual Mechanism Against Autoreactive B Cells
- Yonalimab is a dual-action BAFF‑R antagonist that potently depletes B cells and blocks their maturation.
- It is glycoengineered for stronger B‑cell depletion than anti‑CD20 agents, targeting long‑lived autoreactive plasma cells in ITP.
Preempt Infusion Reactions And Watch For Transient Neutropenia
- Pre-treat patients receiving intravenous yonalimab to reduce infusion reactions and monitor transient neutropenia.
- Infusions last ~2 hours, ~10–15% have mild/moderate reactions, and transient neutropenia occurred without increased infections in VEHIT‑2.
Minimal IgG Drop But Vaccine Response Unclear
- Yonalimab causes only modest IgG decline and unknown effects on new vaccine responses.
- IgG fell ~10–15% after a standard four‑infusion course, so vaccination efficacy post‑treatment remains under study.