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Effectiveness of cryosupernatant therapy in refractory and chronic relapsing thrombotic thrombocytopenic purpura
Author(s) -
Obrador G. T.,
Zeigler Z. R.,
Shadduck R. K.,
Rosenfeld C. S.,
Hanrahan J. B.
Publication year - 1993
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830420214
Subject(s) - thrombotic thrombocytopenic purpura , cryoprecipitate , medicine , fresh frozen plasma , refractory (planetary science) , plasmapheresis , thrombotic microangiopathy , blood coagulation factors , surgery , platelet , gastroenterology , immunology , coagulation , physics , antibody , disease , astrobiology
This report describes objective improvement in two patients with poorly responsive thrombotic thrombocytopenic purpura (TTP) syndromes (with cryosupernatant). The first had a partial response to plasma exchange with whole plasma (fresh frozen plasma; FFP) and responded dramatically when switched to plasma exchange with cryosupernatant replacement. The second had chronic TTP (three relapses in 9 months) that required prolonged courses of exchange with FFP (∼ 1 month each) to achieve remission. Attempts to manage her recurrent TTP with infusion of two units of FFP had been unsuccessful. The latter patient was tried on cryosupernatant infusions (2 units daily) and responded within 4 days. Moreover, she has been in continuous remission for 12 months while receiving 2 units (one to three times per week). These results suggest that cryoprecipitate‐poor plasma may offer advantages over whole plasma in the management of both acute and chronic forms of TTP. © 1993 Wiley‐Liss, Inc.