The Canadian experience using plasma exchange for immune thrombocytopenic purpura

Citation
N. Buskard et al., The Canadian experience using plasma exchange for immune thrombocytopenic purpura, TRANSFUS SC, 19(3), 1998, pp. 295-300
Citations number
17
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology
Journal title
TRANSFUSION SCIENCE
ISSN journal
0955-3886 → ACNP
Volume
19
Issue
3
Year of publication
1998
Pages
295 - 300
Database
ISI
SICI code
0955-3886(199809)19:3<295:TCEUPE>2.0.ZU;2-5
Abstract
The effect of plasma exchange (PE) for the treatment of acute immune thromb ocytopenic purpura (ITP) was assessed both through an analysis of the use o f. PE for ITP in Canada from 1980 to 1997, and in a study of 23 patients; w ith acute ITP. Thirteen of these 23 patients were treated by PE (10 were ex changed with albumin and three with FFP):plus prednisone and 10 were treate d with prednisone alone. At the 6 month follow-up, 11 of 19 patients were c onsidered complete responders and six were considered partial responders. T he difference in response rates between the PE and prednisone groups was no t statistically significant. All patients had platelet specific antibodies at the time of entry into the study. Antibody concentration was reduced fol lowing PE in 10 of the 12 patients tested, and a response to PE was seen in all 10 patients who had a-reduction in the level of platelet antibody. In contrast, antibody levels did not change in the patients who received stero id treatment only. This observation suggests that antibody removal may be o f direct benefit in patients with ITP. Analysis of our results indicated th at PE increased the length of time before splenectomy but did not alter the need for splenectomy. Short term benefits of PE were accomplished with no increase in morbidity or mortality which confirms-that PE is a Safe procedu re in patients with ITP. (C) 1998 Elsevier Science Ltd. All rights reserved .