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  • Title: Response to plasma exchange and steroids as combined therapy for patients with thrombotic thrombocytopenic purpura.
    Author: de la Rubia J, López A, Arriaga F, Cid AR, Vicente AI, Marty ML, Sanz MA.
    Journal: Acta Haematol; 1999; 102(1):12-6. PubMed ID: 10473882.
    Abstract:
    We describe our experience in the management of 11 consecutive patients with thrombotic thrombocytopenic purpura (TTP) treated with a combined therapy of plasma exchange (PE) and steroids. Nine patients (82%) achieved complete remission (CR) after a median of 6 rounds of PE (range 2-22). There were 3 early relapses managed in the same way as the initial episode. One patient relapsed 23 months after diagnosis achieving CR with standard therapy; another patient suffered several relapses, and splenectomy was performed after the last one. Three patients died, 2 of them with resistant disease 9 and 38 days after diagnosis, and the remaining one died due to AIDS-related complications while he was in CR. Eight patients are alive in CR with a median follow-up of 38 months (range 8-74). The combination of PE and steroids is a well-tolerated and effective treatment of TTP, but improvements in therapy are needed to manage refractory patients.
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