Methylene blue‐photoinactivated plasma versus quarantine fresh frozen plasma in thrombotic thrombocytopenic purpura: a multicentric, prospective cohort study

British Journal of Haematology - Tập 143 Số 1 - Trang 39-45 - 2008
Julio del Río-Garma1,2, Alberto Álvarez‐Larrán1,3, Clara Martínez4, Josep Muncunill5, Dolors Castellà6, Javier de la Rubia7, Concepción Zamora8, Mercedes Corral9, Aurora Viejo10, Francisco Ayala de la Peña11, Pilar Rodríguez‐Vicente12, Enric Contreras13, Cristina Arbona14, Consuelo Ramírez15, José Antonio García‐Erce16, Adrián Alegre17, José Mateo4, Arturo Pereira18
1Julio del Río-Garma and Alberto Alvarez-Larrán contributed equally to this article.
2Service of Haematology, Complexo Hospitalario, Ourense
3Service of Haematology, Hospital del Mar, Barcelona
4Unit of Haemostasis & Thrombosis, Hospital de la Santa Creu i Sant Pau, Barcelona
5Service of Haematology, Hospital Son Dureta, Palma de Mallorca
6Banc de Sang i Teixits, Hospital Vall d'Hebron, Barcelona
7Service of Haematology, Hospital La Fe, Valencia
8Service of Haemotherapy, Hospital Ramón y Cajal, Madrid
9Service of Haematology, Hospital Clínico, Salamanca
10Service of Haematology, Hospital La Paz, Madrid
11Service of Haematology, Hospital do Meixoeiro, Vigo
12Service of Haematology, Hospital Central de Asturias, Oviedo
13Banc de Sang i Teixits, Hospital Juan XXIII, Tarragona
14Service of Haematology, Hospital Clínico, Valencia
15Service of Haematology, Hospital Juan Canalejo, A Coruña
16Service of Haematology, Hospital Miguel Servet, Zaragoza
17Service of Haematology, Hospital la Princesa, Madrid
18Service of Haemotherapy & Haemostasis, Hospital Clínic, Barcelona, Spain

Tóm tắt

SummaryPlasma exchange (PE) with plasma infusion is the treatment of choice for thrombotic thrombocytopenic purpura (TTP) but doubts remain as to whether all kinds of plasma are equally effective. A multicentric cohort study was conducted to compare methylene blue‐photoinactivated plasma (MBPIP) with quarantine fresh frozen plasma (qFFP) in the treatment of TTP. One hundred and two episodes of idiopathic TTP were included; MBPIP was used in 63 and qFFP in 39. The treatment schedule consisted of daily PE and costicosteroids, and the main end‐point was remission status on day 8. Patients treated with MBPIP required more PEs (median: 11 vs. 5, P = 0·002) and a larger volume of plasma (median: 485 ml/kg vs. 216 ml/kg, P = 0·007) to achieve a remission, and presented more recrudescences while on PE therapy (29 of 63 vs. 8 of 39, P = 0·02) than those receiving qFFP. After adjustment for possible confounding factors, the use of MBPIP was associated with a lower likelihood of remission on day 8 [Odds ratio (OR): 0·17; 95% confidence interval (CI): 0·06–0·47] and a higher risk of recrudescence while on treatment (OR: 4·2; 95% CI: 1·6–10·8). In conclusion, MBPIP is less effective than qFFP in the treatment of TTP.

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British Journal of Haematology

Tập 143 Số 1

39-45

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