Comparison of 16 patients who were treated with rituximab for their initial episode of TTP with 21 patients who were not treated with rituximab, 2003-2014
| . | Rituximab . | No rituximab . | P* . |
|---|---|---|---|
| Characteristics | |||
| Patients, n | 16 | 21 | — |
| Median age, y (range) | 41 (20-79) | 38 (18-69) | .17 |
| Race, n (% black) | 7 (44) | 8 (38) | .75 |
| Gender, n (% female) | 12 (75) | 15 (71) | 1.00 |
| Initial episode in 2009-2014, n (%) | 10 (63) | 11 (52) | .74 |
| Initial clinical data | |||
| Median hematocrit, % (range) | 22 (8-26) | 21 (13-33) | .42 |
| Median platelets, μL × 103 (range) | 8 (5-29) | 13 (4-63) | .32 |
| Median creatinine, mg/dL (range) | 1.5 (0.8-6.5) | 1.2 (0.8-4.4) | .12 |
| Median LDH, U/L (range) | 1 206 (664-3 319) | 1479 (343-3519) | .73 |
| No. of severe neurologic abnormalities (%) | 8 (50) | 11 (52) | 1.00 |
| Treatment of initial episode | |||
| Median no. of PEX treatments (range) | 16 (5-79) | 8 (5-24) | <.01 |
| Median days from first to last PEX (range) | 21 (5-76) | 8 (5-43) | <.01 |
| Corticosteroid, n (%) | 16 (100) | 21 (100) | — |
| High-dose corticosteroid, n (%) | 6 (38) | 3 (14) | .14 |
| Median corticosteroid total dose, mg (range) | 3 975 (1 000-14 070) | 2135 (300-8870) | .03 |
| Cyclophosphamide, n (%) | 2 (13) | 0 | .18 |
| Vincristine, n (%) | 1 (6) | 0 | .43 |
| . | Rituximab . | No rituximab . | P* . |
|---|---|---|---|
| Characteristics | |||
| Patients, n | 16 | 21 | — |
| Median age, y (range) | 41 (20-79) | 38 (18-69) | .17 |
| Race, n (% black) | 7 (44) | 8 (38) | .75 |
| Gender, n (% female) | 12 (75) | 15 (71) | 1.00 |
| Initial episode in 2009-2014, n (%) | 10 (63) | 11 (52) | .74 |
| Initial clinical data | |||
| Median hematocrit, % (range) | 22 (8-26) | 21 (13-33) | .42 |
| Median platelets, μL × 103 (range) | 8 (5-29) | 13 (4-63) | .32 |
| Median creatinine, mg/dL (range) | 1.5 (0.8-6.5) | 1.2 (0.8-4.4) | .12 |
| Median LDH, U/L (range) | 1 206 (664-3 319) | 1479 (343-3519) | .73 |
| No. of severe neurologic abnormalities (%) | 8 (50) | 11 (52) | 1.00 |
| Treatment of initial episode | |||
| Median no. of PEX treatments (range) | 16 (5-79) | 8 (5-24) | <.01 |
| Median days from first to last PEX (range) | 21 (5-76) | 8 (5-43) | <.01 |
| Corticosteroid, n (%) | 16 (100) | 21 (100) | — |
| High-dose corticosteroid, n (%) | 6 (38) | 3 (14) | .14 |
| Median corticosteroid total dose, mg (range) | 3 975 (1 000-14 070) | 2135 (300-8870) | .03 |
| Cyclophosphamide, n (%) | 2 (13) | 0 | .18 |
| Vincristine, n (%) | 1 (6) | 0 | .43 |
Comparison of the patients who did or did not receive rituximab for an initial episode of TTP, 2003-2014. This patient cohort was selected to begin with the first patient who was treated with rituximab for her refractory initial TTP episode in December 2003. LDH values were adjusted for an upper limit of normal of 200 U/L. Major neurologic abnormalities were primarily transient focal abnormalities; seizures, stroke, and coma also occurred. The median time when rituximab was started was day 11 (day 1 is the day of the first PEX). One patient was treated with corticosteroids and 1 rituximab infusion for an initial diagnosis of primary immune thrombocytopenia 5 d before TTP was diagnosed and PEX was started; she required only 5 PEX sessions; she completed the course of 4 weekly rituximab infusions. High-dose corticosteroid was methylprednisolone, 1000 mg/d for 3 d. The total dose of corticosteroid was calculated in prednisone equivalents for the duration of the hospital treatment of TTP. Posthospital tapering doses of prednisone were not available.
LDH, lactate dehydrogenase.
Median values were compared by the Wilcoxon 2-sample test with t approximation. Fisher’s exact test was used for comparing proportions. Dashes represent data for which statistical comparisons were not appropriate.