Clinical outcomes after platelet transfusions in patients with thrombotic thrombocytopenic purpura

Swisher, Karen K.; Terrell, Deirdra R.; Vesely, Sara K.; Hovinga, Johanna A. Kremer; Lämmle, Bernhard; George, James N.

doi:10.1111/j.1537-2995.2008.02082.x

Cited by 104 publications

(60 citation statements)

References 59 publications

(173 reference statements)

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“…Another particular observation in those patients is that platelet transfusions did not apparently worsen TMA. This finding may be explained by the distinct and specific pathophysiology of cancer-associated TMA, and suggests that platelet transfusions are not a contraindication in this context, as they are for idiopathic TMA in the absence of severe bleeding [23].…”

Section: Discussionmentioning

confidence: 89%

Cancer Awareness in Atypical Thrombotic Microangiopathies

et al. 2009

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After completing this course, the reader will be able to:1. Outline the clinical and biological features that would prompt a clinician to investigate an underlying malignancy in a patient suffering from thrombotic microangiopathy.2. Conduct additional investigation to diagnose or rule out malignancy.3. Formulate in timely fashion an adapted treatment plan for a patient with a cancer-associated thrombotic microangiopathy.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME The Oncologist CME Program is located online at http://cme.theoncologist.com/. ABSTRACTTo take the CME activity related to this article, you must be a registered user. Cancer BiologyThe

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Section: Discussionmentioning

confidence: 89%

Cancer Awareness in Atypical Thrombotic Microangiopathies

et al. 2009

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“…[30][31][32] A systematic review and analysis of data from the Oklahoma TTP-HUS Registry could neither rule in nor rule out adverse outcomes from platelet transfusions and concluded that there was "uncertain evidence of harm." 33 Our large data set suggests that platelets may be associated with 6 times higher odds of developing †Any CNS/gastrointestinal bleeding/genitourinary bleeding is reported as a "documented bleeding. "…”

Section: Discussionmentioning

confidence: 99%

Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality

Goel

Ness

Takemoto

et al. 2015

Blood

203

128

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“…A systematic review of published case reports and case series together with an analysis of our experience did not document a risk from platelet transfusions. 51 Most of our patients received a platelet transfusion. In most of these patients, the platelet transfusions were given as part of the common initial care for patients with severe thrombocytopenia and anemia, before the diagnosis of TTP was considered.…”

Section: Platelet Transfusionsmentioning

confidence: 98%

How I treat patients with thrombotic thrombocytopenic purpura: 2010

George

2010

Blood

Self Cite

430

413

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Thrombotic thrombocytopenic purpura (TTP) is the common name for adults with microangiopathic hemolytic anemia, thrombocytopenia, with or without neurologic or renal abnormalities, and without another etiology; children without renal failure are also described as TTP. The diagnosis of TTP is an indication for plasma exchange treatment, but beginning treatment requires sufficient confidence in the diagnosis to justify the risk of plasma exchange complications. Documentation of a severe deficiency of plasma ADAMTS13 activity, defined as less than 10% of normal, is not essential for the diagnosis of TTP. Some patients without severe ADAMTS13 deficiency may benefit from plasma exchange treatment; in addition, some patients with severe ADAMTS13 deficiency may subsequently be diagnosed with another cause for their clinical features. However, severe acquired ADAMTS13 deficiency does define a subgroup of patients who appear to benefit from treatment with corticosteroids and other immunosuppressive agents in addition to plasma exchange but who have a high risk for relapse. Approximately 80% of patients survive their acute episode, a survival rate that has not changed since the introduction of plasma exchange treatment. Although recovery may appear to be complete, many patients have persistent minor cognitive abnormalities. More effective as well as safer treatment for TTP is needed.

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Clinical outcomes after platelet transfusions in patients with thrombotic thrombocytopenic purpura

Abstract: Evidence for harm from PLT transfusions in patients with TTP is uncertain.

Cited by 104 publications

References 59 publications

Cancer Awareness in Atypical Thrombotic Microangiopathies

Cancer Awareness in Atypical Thrombotic Microangiopathies

Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality

How I treat patients with thrombotic thrombocytopenic purpura: 2010

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