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Treatment of Thrombotic Thrombocytopenic Purpura: Plasmapheresis, Plasma Transfusion, and Vincristine

Treatment of Thrombotic Thrombocytopenic Purpura: Plasmapheresis, Plasma Transfusion, and... Abstract • In four patients with thrombotic thrombocytopenic purpura (TTP), the administration of plasma exchange and vincristine sulfate was associated with reversal of clinical and hematologic evidence of disease. Plasmapheresis with fresh frozen plasma replacement appears effective in acutely improving neurologic and hematologic abnormalities of patients with TTP and provides time for vincristine to become effective and induce lasting remissions. One patient with early relapse responded to a second short course of vincristine without other therapy. These data suggest that these treatment modalities should be considered as the initial treatment of TTP. (Arch Intern Med 1986;146:266-267) References 1. Amorosi EL, Ultmann JE: Thrombotic thrombocytopenic purpura: Report of 16 cases and review of the literature. Medicine 1966;45:139-153.Crossref 2. Bukowski RM: Thrombotic thrombocytopenic purpura: A review. Prog Hemost Thromb 1982;6:287-337. 3. Ridolfi RL, Bell WR: Thrombotic thrombocytopenic purpura: Report of 25 cases and review of the literature. Medicine 1981;60:413-428.Crossref 4. Salky BA, Kreel I, Gelernt IM, et al: Splenectomy for thrombotic thrombocytopenic purpura. Mt Sinai J Med 1983;50:56-59. 5. Birgins H, Ernst P, Hansey M: Thrombotic thrombocytopenic purpura: Treatment with a combination of antiplatelet drugs. Acta Med Scand 1979;205:437-439.Crossref 6. Rosone MH, Ho WG, Goodfinger D: Ineffectiveness of aspirin and dipyridamole in the treatment of thrombotic thrombocytopenic purpura. Semin Thromb Hemost 1981;7:25-31.Crossref 7. Rubinstein MA, Kagan BM, MacGillvary MH, et al: Unusual remission in a case of thrombotic thrombocytopenic purpura syndrome following fresh blood exchange transfusions. Ann Intern Med 1959;51:1409-1419.Crossref 8. Gottschall JL, Pisciotta AV, Darin J, et al: Thrombotic thrombocytopenic purpura: Experience with whole blood exchange transfusion. Semin Thromb Hemost 1981;7:25-31.Crossref 9. Byrnes JJ: Plasma infusion in the treatment of thrombotic thrombocytopenic purpura. Semin Thromb Hemost 1981;7:9-14.Crossref 10. Myers TJ: Treatment of thrombotic thrombocytopenic purpura with combined exchange plasmapheresis and antiplatelet drugs. Semin Thromb Hemost 1981;7:37-42.Crossref 11. Gutterman LA, Stevenson TD: Treatment of thrombotic thrombocytopenic purpura with vincristine. JAMA 1982;247:1433-1436.Crossref 12. Schreeder MT, Prchal JT: Successful treatment of thrombotic thrombocytopenic purpura by vincristine. Am J Hematol 1983;14:75-78.Crossref 13. Thompson HN, McCarthy LJ: Thrombotic thrombocytopenic purpura. Arch Intern Med 1983;143:2117-2119.Crossref 14. Abramson N: Treatments for thrombotic thrombocytopenic purpura: Plasma, vincristine, hemodialysis and exchange transfusions. N Engl J Med 1978;298:971-972.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Treatment of Thrombotic Thrombocytopenic Purpura: Plasmapheresis, Plasma Transfusion, and Vincristine

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References (19)

Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1986.00360140072009
Publisher site
See Article on Publisher Site

Abstract

Abstract • In four patients with thrombotic thrombocytopenic purpura (TTP), the administration of plasma exchange and vincristine sulfate was associated with reversal of clinical and hematologic evidence of disease. Plasmapheresis with fresh frozen plasma replacement appears effective in acutely improving neurologic and hematologic abnormalities of patients with TTP and provides time for vincristine to become effective and induce lasting remissions. One patient with early relapse responded to a second short course of vincristine without other therapy. These data suggest that these treatment modalities should be considered as the initial treatment of TTP. (Arch Intern Med 1986;146:266-267) References 1. Amorosi EL, Ultmann JE: Thrombotic thrombocytopenic purpura: Report of 16 cases and review of the literature. Medicine 1966;45:139-153.Crossref 2. Bukowski RM: Thrombotic thrombocytopenic purpura: A review. Prog Hemost Thromb 1982;6:287-337. 3. Ridolfi RL, Bell WR: Thrombotic thrombocytopenic purpura: Report of 25 cases and review of the literature. Medicine 1981;60:413-428.Crossref 4. Salky BA, Kreel I, Gelernt IM, et al: Splenectomy for thrombotic thrombocytopenic purpura. Mt Sinai J Med 1983;50:56-59. 5. Birgins H, Ernst P, Hansey M: Thrombotic thrombocytopenic purpura: Treatment with a combination of antiplatelet drugs. Acta Med Scand 1979;205:437-439.Crossref 6. Rosone MH, Ho WG, Goodfinger D: Ineffectiveness of aspirin and dipyridamole in the treatment of thrombotic thrombocytopenic purpura. Semin Thromb Hemost 1981;7:25-31.Crossref 7. Rubinstein MA, Kagan BM, MacGillvary MH, et al: Unusual remission in a case of thrombotic thrombocytopenic purpura syndrome following fresh blood exchange transfusions. Ann Intern Med 1959;51:1409-1419.Crossref 8. Gottschall JL, Pisciotta AV, Darin J, et al: Thrombotic thrombocytopenic purpura: Experience with whole blood exchange transfusion. Semin Thromb Hemost 1981;7:25-31.Crossref 9. Byrnes JJ: Plasma infusion in the treatment of thrombotic thrombocytopenic purpura. Semin Thromb Hemost 1981;7:9-14.Crossref 10. Myers TJ: Treatment of thrombotic thrombocytopenic purpura with combined exchange plasmapheresis and antiplatelet drugs. Semin Thromb Hemost 1981;7:37-42.Crossref 11. Gutterman LA, Stevenson TD: Treatment of thrombotic thrombocytopenic purpura with vincristine. JAMA 1982;247:1433-1436.Crossref 12. Schreeder MT, Prchal JT: Successful treatment of thrombotic thrombocytopenic purpura by vincristine. Am J Hematol 1983;14:75-78.Crossref 13. Thompson HN, McCarthy LJ: Thrombotic thrombocytopenic purpura. Arch Intern Med 1983;143:2117-2119.Crossref 14. Abramson N: Treatments for thrombotic thrombocytopenic purpura: Plasma, vincristine, hemodialysis and exchange transfusions. N Engl J Med 1978;298:971-972.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Feb 1, 1986

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