Application of the French TMA Reference Center Score and the mortality in TTP Score in de novo and relapsed episodes of acquired thrombotic thrombocytopenic purpura at a tertiary care facility in Spain

• Published in: Journal of clinical apheresis 2021-06, Vol.36 (3), p.420-428
• Main Authors: Domingo‐González, Amalia, Regalado‐Artamendi, Isabel, Martín‐Rojas, Reyes María, Pérez‐Rus, Gloria, Pérez‐Corral, Ana, Díez‐Martín, José Luis, Pascual‐Izquierdo, Cristina
• Format: Article
• Language: English
• Subjects: acquired thrombotic thrombocytopenic purpura; first episode of TTP; Mortality; Purpura; relapsed TTP; TTP mortality predictive scores
• ISSN: 0733-2459; 1098-1101
• DOI: 10.1002/jca.21880

Acquired thrombotic thrombocytopenic purpura (aTTP) is still associated with a 10% to 20% death rate and its clinical course is characterized by recurrent episodes in up to 50% of cases. Over the last decade, mortality predicting models like the French TMA Reference Center Score and the Mortality In TTP Score (MITS) have been developed in an attempt to personalize treatment. The objective of the present study was to compare the results in both scores of de novo and relapsed aTTP episodes. For such purpose, a total of 29 episodes of aTTP (16 de novo and 13 relapses) were analyzed. All patients were homogeneously diagnosed and treated. First episodes had a higher score in both models in comparison with relapsed aTTP, (MITS median, 1 r: 1‐4 vs 0 r: 1‐2, P = .038 and French TMA Reference Center Score median, 2 r: 1‐3 vs 1 r: 0‐1, P = .006). The prevalence of neurological symptoms was significantly higher in the first episodes (P = .001) and patients >60 years old were more common in this group (P = .013), which may have been related to the results. Platelet count at presentation was higher in recurrences than in the first disease episode (P = .016) and ADAMTS13 activity