title: Methylene blue-photoinactivated plasma versus quarantine fresh frozen plasma in thrombotic thrombocytopenic purpura: a multicentric, prospective cohort study.
abstract: Plasma exchange (PE) with plasma infusion is the treatment of choice for thrombotic thrombocytopenic purpura (TTP) but doubts remain as to whether all kinds of plasma are equally effective. A multicentric cohort study was conducted to compare methylene blue-photoinactivated plasma (MBPIP) with quarantine fresh frozen plasma (qFFP) in the treatment of TTP. One hundred and two episodes of idiopathic TTP were included; MBPIP was used in 63 and qFFP in 39. The treatment schedule consisted of daily PE and costicosteroids, and the main end-point was remission status on day 8. Patients treated with MBPIP required more PEs (median: 11 vs. 5, P = 0.002) and a larger volume of plasma (median: 485 ml/kg vs. 216 ml/kg, P = 0.007) to achieve a remission, and presented more recrudescences while on PE therapy (29 of 63 vs. 8 of 39, P = 0.02) than those receiving qFFP. After adjustment for possible confounding factors, the use of MBPIP was associated with a lower likelihood of remission on day 8 [Odds ratio (OR): 0.17; 95% confidence interval (CI): 0.06-0.47] and a higher risk of recrudescence while on treatment (OR: 4.2; 95% CI: 1.6-10.8). In conclusion, MBPIP is less effective than qFFP in the treatment of TTP.
authors.affiliation: Service of Haematology, Complexo Hospitalario, Ourense, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: del Río-Garma
authors.forename: Alberto
authors.initials: A
authors.lastname: Alvarez-Larrán
authors.forename: Clara
authors.initials: C
authors.lastname: Martínez
authors.forename: Josep
authors.initials: J
authors.lastname: Muncunill
authors.forename: Dolors
authors.initials: D
authors.lastname: Castellà
authors.forename: Javier
authors.initials: J
authors.lastname: de la Rubia
authors.forename: Concepción
authors.initials: C
authors.lastname: Zamora
authors.forename: Mercedes
authors.initials: M
authors.lastname: Corral
authors.forename: Aurora
authors.initials: A
authors.lastname: Viejo
authors.forename: Francisco
authors.initials: F
authors.lastname: Peña
authors.forename: Pilar
authors.initials: P
authors.lastname: Rodríguez-Vicente
authors.forename: Enric
authors.initials: E
authors.lastname: Contreras
authors.forename: Cristina
authors.initials: C
authors.lastname: Arbona
authors.forename: Consuelo
authors.initials: C
authors.lastname: Ramírez
authors.forename: José A
authors.initials: JA
authors.lastname: Garcia-Erce
authors.forename: Adrián
authors.initials: A
authors.lastname: Alegre
authors.forename: José
authors.initials: J
authors.lastname: Mateo
authors.forename: Arturo
authors.initials: A
authors.lastname: Pereira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008027:Light; D016015:Logistic Models; D008297:Male; D008751:Methylene Blue / Q000494:pharmacology*; D008875:Middle Aged; D010949:Plasma / Q000187:drug effects / Q000528:radiation effects; D010951:Plasma Exchange / Q000379:methods*; D011446:Prospective Studies; D011697:Purpura, Thrombotic Thrombocytopenic / Q000628:therapy*; D012074:Remission Induction; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008751:Methylene Blue