Therapeutic modalities in thrombotic thrombocytopenic purpura management among Jehovah's Witness patients : A review of reported cases
Copyright © 2023 Elsevier Ltd. All rights reserved..
INTRODUCTION: Devout members of the Jehovah's Witness faith flatly refuse transfusions of white blood cells, red blood cells, platelets, and plasma. The latter agent is a mainstay in the treatment of thrombotic thrombocytopenic purpura (TTP). Alternative treatment options for Jehovah's Witness patients are needed and reviewed herein.
METHODS: Cases of TTP treatment among Jehovah's Witnesses were obtained from the published literature. Key baseline and clinical data were extracted and summarized.
RESULTS: A total of 13 reports spanning a 23-year period and 15 TTP episodes were identified. Median (IQR) age was 45.5 (29.0-57.5) and 12/13 (93%) patients were female. Neurologic symptoms were present in 7/15 (47%) episodes at presentation. Disease confirmation with ADAMTS13 testing was present in 11/15 (73%) of episodes. Corticosteroids and rituximab were employed in 13/15 (87%) and 12/15 (80%) of cases, respectively, with apheresis-based therapy employed in 9/15 (60%) episodes. For eligible cases, caplacizumab was used in 4/5 (80%) episodes; average time to platelet response was shortest in these cases. Sources of exogenous ADAMTS13 accepted by patients in this series included cryo-poor plasma, FVIII concentrate, and cryoprecipitate.
CONCLUSIONS: Successful management of TTP within the boundaries of the Jehovah's Witness faith is possible.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:62 |
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| Enthalten in: |
Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis - 62(2023), 4 vom: 27. Aug., Seite 103706 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tran, Minh-Ha [VerfasserIn] |
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| Links: |
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| Themen: |
4F4X42SYQ6 |
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| Anmerkungen: |
Date Completed 21.08.2023 Date Revised 21.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.transci.2023.103706 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM354958348 |
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| 245 | 1 | 0 | |a Therapeutic modalities in thrombotic thrombocytopenic purpura management among Jehovah's Witness patients |b A review of reported cases |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Ltd. All rights reserved. | ||
| 520 | |a INTRODUCTION: Devout members of the Jehovah's Witness faith flatly refuse transfusions of white blood cells, red blood cells, platelets, and plasma. The latter agent is a mainstay in the treatment of thrombotic thrombocytopenic purpura (TTP). Alternative treatment options for Jehovah's Witness patients are needed and reviewed herein | ||
| 520 | |a METHODS: Cases of TTP treatment among Jehovah's Witnesses were obtained from the published literature. Key baseline and clinical data were extracted and summarized | ||
| 520 | |a RESULTS: A total of 13 reports spanning a 23-year period and 15 TTP episodes were identified. Median (IQR) age was 45.5 (29.0-57.5) and 12/13 (93%) patients were female. Neurologic symptoms were present in 7/15 (47%) episodes at presentation. Disease confirmation with ADAMTS13 testing was present in 11/15 (73%) of episodes. Corticosteroids and rituximab were employed in 13/15 (87%) and 12/15 (80%) of cases, respectively, with apheresis-based therapy employed in 9/15 (60%) episodes. For eligible cases, caplacizumab was used in 4/5 (80%) episodes; average time to platelet response was shortest in these cases. Sources of exogenous ADAMTS13 accepted by patients in this series included cryo-poor plasma, FVIII concentrate, and cryoprecipitate | ||
| 520 | |a CONCLUSIONS: Successful management of TTP within the boundaries of the Jehovah's Witness faith is possible | ||
| 650 | 4 | |a Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Caplacizumab | |
| 650 | 4 | |a Jehovah’s Witness | |
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| 650 | 4 | |a TTP | |
| 650 | 4 | |a Thrombotic Thrombocytopenic Purpura | |
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