Efficacy of Rituximab in the Treatment of Plasma Exchange Refractory Thrombotic Thrombocytopenic Purpura

Background: rituximab can induce a durable remission in plasma exchange refractory thrombotic thrombocytopenic purpura (ttp). timing of rituximab infusion in combination with plasma exchange (pe) and long term follow-up for probable side effects of such treatment is still lacking. methods: this study was conducted among 10 patients with plasma exchange refractory ttp. according to the study designation, first pe was performed within 36-48 hours after first dose of rituximab. results: eight of ten (80%) patients received 1 course of rituximab. two of ten (20%) patients received another course of rituximab due to relapse. repsonse rate (rr) to rituximab in combination with plasma exchange, was 90%. overall survival of the patients was 90% and 1 and 5-year relapse free survival rate (rfs) was 90% and 83%, respectively. one of the patients expired due to systemic lupus erythematosus flare up. conclusion: according to this study, treatment of refractory ttp with rituximab in combination with pe could be effective.