SUCCESSFUL TREATMENT OF THROMBOTIC THROMBOCYTOPENIC PURPURA WITH PLASMAPHERESIS AND RITUXIMAB-A CASE SERIES

Abstract

Thrombotic thrombocytopenic purpura is a haematological disorder which affects the arterioles and capillaries of multiple organs.We report three cases of TTP successfully treated with plasmapheresis & low dosage rituximab.All three cases were diagnosed according to diagnostic criteria of TTP.A Weekly doses of 100 mg rituximab was given for four week(on day 1,day 8, day15 ,day22).Resolution of clinical symptoms and hemotological abnormalities after completion of treatment, all three patient achieved complete Response. The duration of complete response was 5-27 months. During the treatment course, All three patients were treated with plasmapheresis at different times, the recommended quantity of 9 plasmapheresis was 40 ml/kg once a day and the plasmapheresis was stopped when platelet dose went up to 150x10 . This case series indicates that plasmapheresis may positively support early salvage therapy in both acute/refractory and relapsing cases and its combination with rituximab exhibits short and long term favorable effects for the treatment of TTP.