Abstract | BACKGROUND: METHODS: One hundred two patients with thrombotic thrombocytopenic purpura were randomly assigned to receive either plasma exchange or plasma infusion with fresh-frozen plasma on seven of the first nine days after entry into the trial. The total volume of plasma received by patients undergoing plasma exchange was three times that received by patients undergoing plasma infusion. All the patients also received aspirin and dipyridamole. The outcomes in the two groups were compared at the end of the first treatment cycle (day 9) and after six months. RESULTS: At the end of the first treatment cycle patients receiving plasma exchange had a higher rate of response as defined by an increase in the platelet count (24 of 51 patients) than those who received plasma infusion (13 of 51, P = 0.025). Of the 51 patients treated with plasma exchange, 2 died, whereas 8 of the 51 patients who received plasma infusion died (P = 0.035). After six months the outcome in the plasma-exchange group was still superior, with a response observed in 40 of 51 patients, whereas 25 of 51 patients in the plasma-infusion group responded (P = 0.002). Eleven patients in the plasma-exchange group died, as did 19 patients in the plasma-infusion group (P = 0.036). The overall mortality was 29 percent. CONCLUSIONS:
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Authors | G A Rock, K H Shumak, N A Buskard, V S Blanchette, J G Kelton, R C Nair, R A Spasoff |
Journal | The New England journal of medicine
(N Engl J Med)
Vol. 325
Issue 6
Pg. 393-7
(Aug 08 1991)
ISSN: 0028-4793 [Print] United States |
PMID | 2062330
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adult
- Aspirin
(therapeutic use)
- Blood Transfusion
- Dipyridamole
(therapeutic use)
- Female
- Humans
- Male
- Monitoring, Physiologic
- Plasma
- Plasma Exchange
- Platelet Count
- Prospective Studies
- Purpura, Thrombotic Thrombocytopenic
(blood, mortality, therapy)
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