From the Research
Plasmapheresis for thrombotic thrombocytopenic purpura (TTP) should be continued daily until the patient's platelet count normalizes and clinical symptoms resolve, with the most recent study suggesting treatment duration is variable but often continues until a response is obtained 1. The goal of plasmapheresis in TTP is to remove autoantibodies against ADAMTS13 and replenish this enzyme through donor plasma, thereby improving platelet counts and reducing clinical symptoms.
- Key factors associated with the achievement of complete response (CR) include the fall in LDH at D5 of treatment and the daily rhythm of plasmapheresis 1.
- The standard approach involves exchanging 1-1.5 plasma volumes per session, with each session usually lasting 2-4 hours.
- Treatment should continue for at least 2 days after platelet counts normalize to prevent immediate relapse.
- Close monitoring of platelet counts, hemoglobin, LDH, and clinical symptoms is essential to determine when plasmapheresis can be safely discontinued.
- Some patients may require adjunctive therapy with corticosteroids, rituximab, or caplacizumab, particularly those with refractory disease or relapse 1, 2.