Abstract
Platelet (PLT) transfusions are probably harmful in patients with acquired idiopathic thrombotic thrombocytopenic purpura (aTTP). Introduction of a rapid assay for ADAMTS13 activity should reduce the time to definite diagnosis of aTTP, reduce the amount of inappropriately transfused PLT concentrates, and improve mortality and morbidity. We selected 265 aTTP patients with severe ADAMTS13 deficiency. Of these, 91 patients were diagnosed by March 2005 (Period 1), when ADAMTS13 activity was measured by von Willebrand factor multimer assay, which took 4 to 7 days until the result was reported. An additional 174 patients were diagnosed after April 2005 (Period 2), when the activity was measured by a chromogenic enzyme-linked immunosorbent assay, which took 1 to 2 days. We found no significant differences in 30-day survival rate between the two periods. Overall, 48 patients received PLT transfusions. Mortality was slightly greater between patients with (22.9%) versus without PLT transfusion (17.7%), but not significant. In Period 1, Cox proportional hazards regression analysis showed that older age (≥60 years) and PLT transfusion administration were independent factors associated with higher risks of 30-day mortality. In contrast, in ...Continue Reading
References
Aug 8, 1991·The New England Journal of Medicine·G A RockR A Spasoff
Sep 1, 1987·The American Journal of Medicine·M Rose, A Eldor
Jul 1, 1966·Naika. Internal medicine·Y SugaM Nomura
Jun 1, 1980·The Journal of Clinical Investigation·Z M Ruggeri, T S Zimmerman
Oct 23, 1981·JAMA : the Journal of the American Medical Association·D R HarknessG T Hensley
Nov 26, 1998·The New England Journal of Medicine·M FurlanB Lämmle
Nov 26, 1998·The New England Journal of Medicine·H M Tsai, E C Lian
Oct 5, 2001·Nature·G G LevyH M Tsai
Jan 5, 2002·American Journal of Hematology·P CoppoA Bussel
Jun 27, 2002·Transfusion·Yoshitaka MoriYoshihiro Fujimura
Nov 9, 2002·Transfusion·Javier de la RubiaMaría L Marty
Sep 27, 2003·Blood·Koichi KokameToshiyuki Miyata
Dec 24, 2005·Transfusion·Miguel LozanoRoberto Mazzara
Aug 29, 2006·Transfusion·Seiji KatoYoshihiro Fujimura
Feb 13, 2009·Transfusion·Karen K SwisherJames N George
Dec 25, 2009·Blood·Johanna A Kremer HovingaJames N George
Jan 5, 2010·Internal Medicine·Yoshihiro Fujimura, Masanori Matsumoto
Oct 1, 2010·Indian Journal of Pediatrics·Sushil P TripathiRajesh K Kulkarni
Aug 4, 2011·Journal of Thrombosis and Haemostasis : JTH·Y FujimuraT Miyata
May 26, 2012·British Journal of Haematology·Marie ScullyUNKNOWN British Committee for Standards in Haematology
Dec 5, 2012·Bone Marrow Transplantation·Y Kanda
May 31, 2013·Journal of Clinical Apheresis·Steven M Duffy, Thomas E Coyle
Nov 13, 2014·Transfusion·Ambuj KumarUNKNOWN AABB Platelet Transfusion Guidelines Panel
Jan 16, 2015·Blood·Ruchika GoelAaron A R Tobian
Mar 6, 2015·American Journal of Hematology·Ygal BenhamouPaul Coppo
Apr 23, 2015·Vox Sanguinis·Z K OtrockB J Grossman
Dec 8, 2015·Hematology·J Evan Sadler
Nov 22, 2016·Journal of Thrombosis and Haemostasis : JTH·M ScullyUNKNOWN International Working Group for Thrombotic Thrombocytopenic Purpura
Citations
Oct 8, 2019·Intensive Care Medicine·Elie AzoulayUNKNOWN Nine-i Investigators
Jul 17, 2018·Thrombosis Journal·Hideo WadaMasanori Matsumoto
Nov 13, 2020·Transfusion·Angela LiuShruti Chaturvedi
Dec 17, 2020·Clinical Chemistry and Laboratory Medicine : CCLM·Emanuela FalcinelliPaolo Gresele