Therapeutic plasma exchange taper does not decrease exacerbations in immune thrombotic thrombocytopenic purpura patients.

Transfusion
Jay S RavalYara A Park

Abstract

Despite rapid and intensive treatments with therapeutic plasma exchange (TPE) and immunosuppression, immune thrombotic thrombocytopenic purpura (TTP) patients are at risk of disease exacerbation, i.e., early recurrence of TTP within 30 days of achieving treatment response. TPE taper, a practice of performing additional TPE procedures after achieving treatment response, is commonly performed for decreasing exacerbations, although no evidence supports this practice. In this prospective observational investigation over four years, our center switched its standard of care for treating all TTP patients from not performing TPE taper after achieving treatment response (i.e., no-taper cohort) to performance of TPE taper (i.e., yes-taper cohort) to characterize impacts on exacerbations. Continuous and categorical data were analyzed by Mann-Whitney, Fisher's exact, and log-rank tests; significance was defined as p < 0.05. The two cohorts were well matched and had no significant differences in demographics, presentation laboratory values, or TTP history (p > 0.05 for all). The yes-taper cohort of 26 patients with 29 consecutive episodes did not have a significantly different exacerbation rate from the no-taper cohort of 24 patients with 2...Continue Reading

References

Mar 18, 1999·Therapeutic Apheresis : Official Journal of the International Society for Apheresis and the Japanese Society for Apheresis·L L BraileyN Bandarenko
Aug 28, 2007·Journal of Clinical Apheresis·Douglas SheminMelanie Greenan
Aug 10, 2013·Transfusion·Jessica L ScottMarisa B Marques
Oct 15, 2013·Journal of Clinical Apheresis·Jay S RavalJoseph E Kiss
Jan 7, 2014·British Journal of Haematology·Marie Scully, Tim Goodship
Jul 30, 2014·Transfusion·Jay S RavalYara A Park
Apr 17, 2016·Lancet·Meghan DelaneyUNKNOWN Biomedical Excellence for Safer Transfusion (BEST) Collaborative
Apr 20, 2016·Journal of Clinical Apheresis·Jay S RavalUNKNOWN American Society for Apheresis Clinical Applications Committee
Aug 1, 2016·Journal of Clinical Apheresis·Christopher J PatriquinUNKNOWN Canadian Apheresis Group
Oct 28, 2019·Transfusion Medicine Reviews·Marshall A MazepaJay S Raval

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Citations

Jan 19, 2021·Transfusion·Christopher J Patriquin, Katerina Pavenski
Jul 20, 2021·Expert Review of Hematology·Inés Gómez-SeguíJavier de la Rubia Comos
Jul 17, 2021·Medicina clínica·María Eva Mingot CastellanoUNKNOWN Grupo Español de Aféresis (GEA)

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