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Advances in Hematology
Volume 2013, Article ID 195746, 4 pages
http://dx.doi.org/10.1155/2013/195746
Research Article

Approach to Management of Thrombotic Thrombocytopenic Purpura at University of Cincinnati

1Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
2Division of Hematology and Oncology, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267, USA
3Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
4Department of Hematology and Oncology, Baylor College of Medicine, Houston, TX 76706, USA
5Hoxworth Blood Center, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA

Received 23 September 2013; Revised 14 November 2013; Accepted 28 November 2013

Academic Editor: Estella M. Matutes

Copyright © 2013 N. Abdel Karim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Thrombotic Thrombocytopenic Purpura (TTP) is a rare hematologic emergency, congenital or acquired, characterized by ischemic damage of various organs because of platelet aggregation. It 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. Plasma exchange (PE) is the main stay of treatment in combination with steroids and immunosuppressive therapies. The monoclonal antibody against CD20 Rituximab decreases the production of antibodies from B lymphocytes and it is used for antibodies-mediated diseases including TTP. We present our data on retrospective analysis of rituximab in treatment of TTP at University of Cincinnati in a series of 22 patients from 1997 to 2009. Our results showed that PE with immunosuppressive therapy resulted in decreased duration of PE, relapse rate, and increased duration of remission in patients with TTP.