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dc.contributor.authorFrawley, Natashaen_US
dc.contributor.authorNG, ASHLEYen_US
dc.contributor.authorNICHOLLS, KATHLEENen_US
dc.contributor.authorHogan, Chrisen_US
dc.contributor.authorCOHNEY, SOLOMONen_US
dc.contributor.authorGRIGG, ANDREWen_US
dc.date.accessioned2014-05-22T14:06:02Z
dc.date.available2014-05-22T14:06:02Z
dc.date.issued2008en_US
dc.date.submitted2008-05-26en_US
dc.identifier.citationFrawley, N., Ng, A., Nicholls, K., Hogan, C., Cohney, S., & Grigg, A. (2008). Thrombotic thrombocytopenic purpura is associated with a high relapse rate after plasma exchange: a single-centre experience. Internal Medicine Journal.en_US
dc.identifier.urihttp://hdl.handle.net/11343/34964
dc.descriptionThis is a pre-print version of an article submitted for publication in Internal Medicine Journal. doi:10.1111/j.14455994.2008.01637.x http://www.blackwellpublishing.com/journal.asp?ref=1444-0903&site=1en_US
dc.description.abstractBackground: Thrombotic thrombocytopenic purpura (TTP) is a rare condition characterized by microangiopathic haemolytic anaemia, thrombocytopenia, renal and/or neurological dysfunction secondary to microvascular or macrovascular thrombosis. Despite advances in treatment, TTP remains a serious condition with significant morbidity and mortality. Methods: We undertook an audit of patients with TTP over 14 years to assess remission, relapse, survival and factors predictive of outcome using current therapy based on plasma exchange with fresh-frozen plasma. Results: Forty patients were identified between January 1992 and December 2005. Thirty-one (82%) achieved complete response (CR) to therapy using plasma exchange with fresh-frozen plasma (median 11 exchanges) and steroids. Twelve (37%) relapsed a median of 14 days following cessation of therapy, with multiple relapses occurring in two patients. TTP-related death occurred in four patients during their initial presentation and in two during subsequent relapse. Four patients were only partially responsive to first-line therapy. The absence of neurological features at presentation was the only factor predicting a sustained CR to first-line therapy (P = 0.027, log–rank analysis). The mean duration of inpatient treatment was 18 days (range 4–38 days) with 30% of patients requiring intensive care admission. Thirty-four per cent of patients acquired central venous line infection, with a median of two episodes of line sepsis per patient. Conclusion: Our results indicate the need for better treatments to reduce the high early relapse rate and significant mortality associated with current therapy.en_US
dc.formatapplication/pdfen_US
dc.languageengen_US
dc.publisherBlackwell Snergyen_US
dc.subjectthrombotic thrombocytopenic purpuraen_US
dc.subjectneurological featureen_US
dc.subjectplasma exchangeen_US
dc.subjectsteroiden_US
dc.subjectrituximab.en_US
dc.titleThrombotic thrombocytopenic purpura is associated with a high relapse rate after plasma exchange: a single-centre experienceen_US
dc.typeJournal (On-line/Unpaginated)en_US
melbourne.peerreviewPeer Revieweden_US
melbourne.affiliation.departmentSchool of Medicineen_US
melbourne.publication.statusPublisheden_US
melbourne.source.titleInternal Medicine Journalen_US
melbourne.publicationid202682en_US
melbourne.elementsidNA
melbourne.contributor.authorNg, Ashley
melbourne.contributor.authorNicholls, Kathleen
melbourne.contributor.authorHogan, Christopher
melbourne.contributor.authorCohney, Solomon
melbourne.contributor.authorGrigg, Andrew
melbourne.accessrightsOpen Access


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