Tapering therapy after an initial response in a patient with immune thrombotic thrombocytopenic purpura (iTTP)

This approach applies to individuals with immune TTP who have had an initial platelet count response.^* Refer to UpToDate topics on treatment of immune TTP for additional details about monitoring and interventions.

CBC: complete blood count; LDH: lactate dehydrogenase; TPE: therapeutic plasma exchange; TTP: thrombotic thrombocytopenic purpura.

* Defined as a platelet count ≥150,000/microL for at least 2 days or a stable platelet count plateau in the normal or supranormal range for 3 days. Refer to UpToDate for details.

¶ Daily assessment of clinical status, CBC, and LDH is done for approximately 2 to 3 days after stopping TPE; monitoring is then extended slowly, with the exact timing dependent on clinical status.

Δ Individuals who have a recurrence within a month of the acute episode are considered to have refractory disease and are treated more aggressively. Those who have a recurrence >1 month after the acute episode are considered to have a relapse and are treated for a new episode, similarly to the previous episode. Refer to the UpToDate for additional details.

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Tapering therapy after an initial response in a patient with immune thrombotic thrombocytopenic purpura (iTTP)