Immune thrombotic thrombocytopenic purpura in older patients: Results from the Spanish TTP Registry (REPTT).
Inés Gómez-SeguíE Francés AracilMaria-Eva Mingot-CastellanoM Vara PampliegaR Goterris ViciedoF García CandelC Pascual IzquierdoJ Del Río GarmaL Guerra DomínguezI Vicuña AndrésJ Garcia-Arroba PeinadoS Zalba MarcosJ M Vidan EstévezE González AriasV Campuzano SaavedraJ M García GalaS Ortega SanchezJ Martínez NietoL Pardo GambarteM Solé RodríguezM Fernández-DocampoL F Avila IdrovoL HernándezJoan CidJavier de la Rubianull nullPublished in: British journal of haematology (2023)
Immune thrombotic thrombocytopenic purpura (iTTP) is an ultra-rare disease that seldom occurs in the elderly. Few reports have studied the clinical course of iTTP in older patients. In this study, we have analysed the clinical characteristics at presentation and response to therapy in a series of 44 patients with iTTP ≥60 years at diagnosis from the Spanish TTP Registry and compared them with 209 patients with <60 years at diagnosis from the same Registry. Similar symptoms and laboratory results were described in both groups, except for a higher incidence of renal dysfunction among older patients (23% vs. 43.1%; p = 0.008). Front-line treatment in patients ≥60 years was like that administered in younger patients. Also, no evidence of a difference in clinical response and overall survival was seen in both groups. Of note, 14 and 25 patients ≥60 years received treatment with caplacizumab and rituximab, respectively, showing a favourable safety and efficacy profile, like that observed in patients <60 years.