Steroids and antiplatelet agents are used. Steroids are often used prior to plasma exchange. Antiplatelet agents are used, but hemorrhage is a concern and the agent's benefit has not been proven. Aspirin and dipyridamole are recommended by some, but their use is controversial. Other antiplatelet agents ticlopidine and prostacyclin have variable outcomes.
Some patients benefit from the splenectomy.
The response may be due to the removal of the site of sequestration of the red blood cell and platelet. Treatment for refractory or relapsing TTP includes vincristine, a second-line therapy with an unknown mechanism of action. Vincristine is occasionally given to treat resistant cases, but has no proven benefit. Supportive care for end-organ damage may be required. Hemodialysis is occasionally required for renal failure.