Kenneth H. Shumak, MD; Gail A. Rock, PhD, MD; Rama C. Nair, PhD; The Canadian Apheresis Group.
Shumak KH, Rock GA, Nair RC, The Canadian Apheresis Group.. Late Relapses in Patients Successfully Treated for Thrombotic Thrombocytopenic Purpura. Ann Intern Med. 1995;122:569-572. doi: 10.7326/0003-4819-122-8-199504150-00002
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Published: Ann Intern Med. 1995;122(8):569-572.
To determine the incidence and timing of relapses in patients who have recovered from an acute episode of thrombotic thrombocytopenic purpura.
Clinical follow-up for 3 to 10 years.
General community outpatient study; patients who had relapse were hospitalized.
63 of 72 surviving patients who had participated in a randomized study that compared plasma exchange and plasma infusion as treatments for thrombotic thrombocytopenic purpura and for whom continued clinical follow-up was obtained.
Recurrence of thrombotic thrombocytopenic purpura as defined by a decrease in platelet count to less than 100 × 109/L and by the onset of microangiopathic hemolytic anemia as identified by erythrocyte fragmentation in a peripheral blood film.
37 of the 63 patients have not had recurrence of thrombotic thrombocytopenic purpura and have remained completely well; 6 patients have not had recurrence but have developed other medical problems; 3 patients have not had recurrence but have residual neurologic defects from the original episode; and 17 patients have had one or more recurrences, occurring 7 months to 8 years after the original episode. As determined by Kaplan-Meier analysis, the projected recurrence rate after 10 years in all surviving patients is 36% (95% CI, 23% to 59%).
More than one third of patients who survive an acute episode of thrombotic thrombocytopenic purpura will have at least one relapse during the following 10 years.
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Coagulopathies, Hematology/Oncology, Platelet Disorders.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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