Therapeutic Plasma Exchange
Authors: William F. Clark, Gail Rock, Kenneth A. Shumak
Journal: Annals of Internal Medicine (2000)

Letters2 May 2000Therapeutic Plasma ExchangeWilliam F. Clark, MD, FRCPC, Gail Rock, PhD, MD, and Kenneth A. Shumak, MD, FRCPCWilliam F. Clark, MD, FRCPCLondon Health Sciences Centre; London, Ontario N6A 4G5, Canada (Clark)Ottawa Hospital; Ottawa, Ontario K1L 5A2, Canada (Rock)University of Toronto; Toronto, Ontario M4N 3M5, Canada (Shumak)Search for more papers by this author, Gail Rock, PhD, MDLondon Health Sciences Centre; London, Ontario N6A 4G5, Canada (Clark)Ottawa Hospital; Ottawa, Ontario K1L 5A2, Canada (Rock)University of Toronto; Toronto, Ontario M4N 3M5, Canada (Shumak)Search for more papers by this author, and Kenneth A. Shumak, MD, FRCPCLondon Health Sciences Centre; London, Ontario N6A 4G5, Canada (Clark)Ottawa Hospital; Ottawa, Ontario K1L 5A2, Canada (Rock)University of Toronto; Toronto, Ontario M4N 3M5, Canada (Shumak)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-9-200005020-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Fakhouri and colleagues for commenting on our article and sharing their experience with six cases of TTP treated with plasma infusion. They question the validity of Rock and coworkers' study, which compared a plasma infusion regimen with a plasma exchange regimen, both in the first cycle and over long-term follow-up (1). We agree that the patients receiving plasma exchange did receive larger volumes of plasma, but the duration of therapy in the first cycle was similar and the outcomes were different. At the end of the first treatment cycle, the response rate (defined by an increase ...References1. Rock GA, Shumak KH, Buskard NA, Blanchette VS, Kelton JG, Nair RC, et al . Comparison of plasma exchange with plasma infusion in the treatment of thrombotic thrombocytopenic purpura. N Engl J Med. 1991;325:393-7. CrossrefMedlineGoogle Scholar2. Furlan M, Robles R, Galbusera M, Remuzzi G, Kyrle PA, Brenner B, et al . von Willebrand factor-cleaving protease in thrombotic thrombocytopenic purpura and the hemolytic-uremic syndrome. N Engl J Med. 1998;339:1578-84. CrossrefMedlineGoogle Scholar3. Tsai HM, Lian EC. Antibodies to von Willebrand factor-cleaving protease in acute thrombotic thrombocytopenic purpura. N Engl J Med. 1998;339:1585-94. CrossrefMedlineGoogle Scholar4. Bell WR, Hayden G, Braine MD, Ness PM, Kickler TS. Improved survival in thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: clinical experience in 108 patients. N Engl J Med. 1991;325:398-403. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: William F. Clark, MD, FRCPC; Gail Rock, PhD, MD; Kenneth A. Shumak, MD, FRCPCAffiliations: London Health Sciences Centre; London, Ontario N6A 4G5, Canada (Clark)Ottawa Hospital; Ottawa, Ontario K1L 5A2, Canada (Rock)University of Toronto; Toronto, Ontario M4N 3M5, Canada (Shumak) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTherapeutic Plasma Exchange: An Update from the Canadian Apheresis Group William F. Clark , Gail A. Rock , Noel Buskard , Kenneth H. Shumak , Pierre LeBlond , David Anderson , David M. Sutton , and Therapeutic Plasma Exchange Fadi Fakhouri , François Vincent , and Christophe Legendre Metrics 2 May 2000Volume 132, Issue 9Page: 760-761KeywordsAntibodiesBlood plasmaHemolytic-uremic syndromePlateletsProteases ePublished: 15 August 2000 Issue Published: 2 May 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...