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Therapeutic plasma exchange-free treatment for first-episode TTP: A systematic review.
Wang, Jiang; Cheng, Fu; Niu, Yingying; Yan, Lingli; Li, Jiaheng; Tan, Bin; Qin, Li.
Afiliación
  • Wang J; Department of Transfusion Medicine, West China Hospital of Sichuan University, Chengdu, China.
  • Cheng F; Department of Transfusion Medicine, West China Hospital of Sichuan University, Chengdu, China.
  • Niu Y; Department of Transfusion Medicine, West China Hospital of Sichuan University, Chengdu, China.
  • Yan L; Department of Transfusion Medicine, West China Hospital of Sichuan University, Chengdu, China.
  • Li J; Department of Transfusion Medicine, West China Hospital of Sichuan University, Chengdu, China.
  • Tan B; Department of Transfusion Medicine, West China Hospital of Sichuan University, Chengdu, China. Electronic address: tanbinhx@163.com.
  • Qin L; Department of Transfusion Medicine, West China Hospital of Sichuan University, Chengdu, China. Electronic address: qinli7@126.com.
Transfus Apher Sci ; 62(3): 103661, 2023 Jun.
Article en En | MEDLINE | ID: mdl-36878741
OBJECTIVE: Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy (TMA), and therapeutic plasma exchange (TPE) is currently the standard treatment. However, TPE sometimes cannot be implemented. The aim of this study was to systematically review patients with a first TTP episode who were treated without TPE. METHOD: The PubMed, Embase, Web of Science and Cochrane Library databases were searched by two investigators independently to collect case reports and clinical studies on TTP patients treated without TPE. After removing duplicate records and records that did not meet the inclusion criteria, the patients' data of eligible studies, including the basic characteristics, treatment regimens, and outcomes were extracted for further analysis. RESULTS: A total of 5338 potentially relevant original studies were identified, from which 21 studies, including 14 cases, 3 case series and 4 retrospective studies, met eligibility requirements and were included. Treatment regimens in the absence of TPE were found to vary based on individual information. Most patients recovered, with normal platelet counts and ADAMT13 activity at discharge. In the meta-analysis of retrospective studies, the TPE-free group had no higher mortality than the TPE-treated group. CONCLUSION: Our study shows that TPE-free treatment may not increase the mortality of TTP patients, which provides a new treatment concept for patients with first episodes of TTP. However, the current evidence is not high due to the lack of randomized controlled trials, so more well-designed prospective clinical trials are warranted to investigate the safety and efficacy of TPE-free treatment regimens in TTP patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Púrpura Trombocitopénica Trombótica Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Transfus Apher Sci Asunto de la revista: HEMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Púrpura Trombocitopénica Trombótica Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Transfus Apher Sci Asunto de la revista: HEMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido