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Previous studies reported that adding rituximab to plasma exchange (PEX) and steroids for patients with thrombotic thrombocytopenic purpura (TTP) decreased hospital stay and the frequency of relapse (NEJM JW Oncol Hematol Sep 2011 and Blood 2011; 118:1746). However, these were small, nonrandomized studies that used historical controls.
To further examine whether patients with idiopathic TTP receiving rituximab as well as PEX and steroids have better outcomes than patients not receiving rituximab, investigators reviewed the records of all 41 patients in the Oklahoma TTP registry. These patients were treated between 2003 and 2014, and all had severe disease (ADAMTS1 activity, <10%).
Rituximab was given to 16 patients, either because of failure …