Therapeutic plasma exchange in patients with thrombotic thrombocytopenic purpura: A retrospective multicenter study

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dc.authoridYılmaz, Mehmet/0000-0002-4368-8453
dc.authoridYILMAZ, Mehmet/0000-0002-5710-5263
dc.authoriddemir, cengiz/0000-0001-9856-184X
dc.authoridKeklik, Muzaffer/0000-0002-6426-5249
dc.authoridokan, vahap/0000-0002-9869-8181
dc.authoridYILMAZ, MEHMET BIRHAN/0000-0002-8169-8628
dc.authoridAltuntas, Fevzi/0000-0001-6872-3780
dc.authorwosidYılmaz, Mehmet/HTO-6056-2023
dc.authorwosidŞencan, Mehmet/AAA-9163-2022
dc.authorwosidYILMAZ, Mehmet/HKM-4739-2023
dc.authorwosiddemir, cengiz/JZE-3811-2024
dc.authorwosidKeklik, Muzaffer/B-3037-2016
dc.authorwosidilhan, osman/ABC-8182-2021
dc.authorwosidokan, vahap/AAH-1424-2020
dc.contributor.authorKorkmaz, Serdal
dc.contributor.authorKeklik, Muzaffer
dc.contributor.authorSivgin, Serdar
dc.contributor.authorYildirim, Rahsan
dc.contributor.authorTombak, Anil
dc.contributor.authorKaya, Mehmet Emin
dc.contributor.authorAcik, Didar Yanardag
dc.date.accessioned2024-08-04T20:37:38Z
dc.date.available2024-08-04T20:37:38Z
dc.date.issued2013
dc.departmentİnönü Üniversitesien_US
dc.description.abstractThrombotic thrombocytopenic purpura (TIT) is a particular form of thrombotic microangiopathy typically characterized by thrombocytopenia, microangiopathic hemolytic anemia, fever, neurological abnormalities, and renal dysfunction. UP requires a rapid diagnosis and an adapted management in emergency. Daily sessions of therapeutic plasma exchange (TPE) remain the basis of management of UP. Also, UP is a rare disease that is fatal if it is not treated. TPE has resulted in excellent remission and survival rates in UP patients. Aim: We aimed to present our experience in 163 patients with UP treated with TPE during the past 5 years from 10 centers of Turkey. Patients and methods: One hundered and sixty-three patients with UP treated with TPE during the past 5 years from 10 centers of Turkey were retrospectively evaluated. TPE was carried out 1-1.5 times plasma volume. Fresh frozen plasma (FFP) was used as the replacement fluid. TPE was performed daily until normalization of serum lactate dehydrogenase (LDH) and recovery of the platelet count to >150 x 10(9)/dL. TPE was then slowly tapered. Clinical data, the number of TPE, other given therapy modalities, treatment outcomes, and TPE complications were recorded. Results: Fifty-eight percent (95/163) of the patients were females. The median age of the patients was 42 years (range; 16-82). The median age of male patients was significantly higher than female (53 vs. 34 years; p < 0.001). All patients had thrombocytopenia and microangiopathic hemolytic anemia. At the same time, 82.8% (135/163) of patients had neurological abnormalities, 78.5% (128/163) of patients had renal dysfunction, and 89% (145/163) of patients had fever. Also, 10.4% (17/163) of patients had three of the five criteria, 10.4% (17/163) of patients had four of the five criteria, and 6.1% (10/163) of patients had all of the five criteria. Primary UP comprised of 85.9% (140/163) of the patients and secondary UP comprised of 14.1% (23/163) of the patients. Malignancy was the most common cause in secondary UP. The median number of TPE was 13 (range; 1-80). The number of TPE was significantly higher in complete response (CR) patients (median 15.0 vs. 3.5; p < 0.001). CR was achieved in 85.3% (139/163) of the patients. Similar results were achieved with TPE in both primary and secondary UP (85% vs. 87%, respectively; p = 0.806). There was no advantage of TPE + prednisolone compared to TPE alone in terms of CR rates (82.1% vs. 76.7%; p = 0.746). CR was not achieved in 14.7% (24/163) of the patients and these patients died of TTP related causes. There were no statistical differences in terms of mortality rate between patients with secondary and primary TIT [15% (21/140) vs. 13% (3/23); p = 0.8061. But, we obtained significant statistical differences in terms of mortality rate between patients on TPE alone and TPE + prednisolone [14% (12/86) vs. 3% (2/67), p < 0.001]. Conclusions: TPE is an effective treatment for UP and is associated with high CR rate in both primary and secondary UP. Thrombocytopenia together with microangiopathic hemolytic anemia is mandatory for the diagnosis of UP and if these two criteria met in a patient, TPE should be performed immediately. (C) 2013 Elsevier Ltd. All rights reserved.en_US
dc.identifier.doi10.1016/j.transci.2013.04.016
dc.identifier.endpage358en_US
dc.identifier.issn1473-0502
dc.identifier.issue3en_US
dc.identifier.pmid23602056en_US
dc.identifier.scopus2-s2.0-84878855493en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage353en_US
dc.identifier.urihttps://doi.org/10.1016/j.transci.2013.04.016
dc.identifier.urihttps://hdl.handle.net/11616/96091
dc.identifier.volume48en_US
dc.identifier.wosWOS:000321403400017en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherPergamon-Elsevier Science Ltden_US
dc.relation.ispartofTransfusion and Apheresis Scienceen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectThrombotic thrombocytopenic purpuraen_US
dc.subjectTherapeutic plasma exchangeen_US
dc.subjectFresh frozen plasmaen_US
dc.subjectComplete responseen_US
dc.titleTherapeutic plasma exchange in patients with thrombotic thrombocytopenic purpura: A retrospective multicenter studyen_US
dc.typeArticleen_US

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