Abstract | BACKGROUND: DESIGN AND METHODS: In 109 patients enrolled in an international registry we evaluated, in the frame of a retrospective cohort study, the predictive role of the metalloprotease ADAMTS13 as measured in plasma during remission. Anti-ADAMTS13 antibodies and von Willebrand factor were also evaluated in a smaller number of the same patients. RESULTS: Median values of ADAMTS13 activity and antigen were significantly lower in patients with recurrent thrombotic thrombocytopenic purpura than in those with no recurrence (activity: 12% vs. 41%; p=0.007; antigen: 36% vs. 58%; p=0.003). A severe deficiency of ADAMTS13 activity (10% or less) was associated with a higher likelihood of recurrence (odds ratio 2.9; 95% confidence interval 1.3 to 6.8; p=0.01). Anti-ADAMTS13 antibodies were also more prevalent in patients with recurrent thrombotic thrombocytopenic purpura (odds ratio 3.1; 95% confidence interval 1.4 to 7.3; p=0.006). The presence during remission of both severe ADAMTS13 deficiency and anti-ADAMTS13 antibodies increased the likelihood of recurrence 3.6 times (95% confidence interval 1.4 to 9.0; p=0.006). The presence of ultralarge von Willebrand factor multimers and of associated diseases or conditions did not increase recurrence. CONCLUSIONS:
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Authors | Flora Peyvandi, Silvia Lavoretano, Roberta Palla, Hendrik B Feys, Karen Vanhoorelbeke, Tullia Battaglioli, Carla Valsecchi, Maria Teresa Canciani, Fabrizio Fabris, Samo Zver, Marienn Réti, Danijela Mikovic, Mehran Karimi, Gaetano Giuffrida, Luca Laurenti, Pier Mannuccio Mannucci |
Journal | Haematologica
(Haematologica)
Vol. 93
Issue 2
Pg. 232-9
(Feb 2008)
ISSN: 1592-8721 [Electronic] Italy |
PMID | 18223285
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Chemical References |
- Autoantibodies
- Biomarkers
- von Willebrand Factor
- ADAM Proteins
- ADAMTS13 Protein
- ADAMTS13 protein, human
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Topics |
- ADAM Proteins
(blood, immunology)
- ADAMTS13 Protein
- Adolescent
- Adult
- Aged
- Autoantibodies
(blood, immunology)
- Biomarkers
(blood)
- Child
- Child, Preschool
- Cohort Studies
- Female
- Humans
- Infant
- Male
- Middle Aged
- Purpura, Thrombotic Thrombocytopenic
(blood, immunology, mortality)
- Recurrence
- Registries
- Remission Induction
- Retrospective Studies
- Risk Factors
- von Willebrand Factor
(analysis, immunology)
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