SUCCESSFUL USE OF CYCLOSPORINE-A IN THE TREATMENT OF REFRACTORY THROMBOTIC THROMBOCYTOPENIC PURPURA

Thrombotic thrombocytopenic purpura (TTP) is, in most cases, treatable with plasma exchange therapy (PLEX). Rarely, patients do not respond to PLEX or develop refractory disease despite an initial remission. In these cases, treatment options are limited and the response to establ ished alternative therapies is often disappointing. We report the case of a paediatric patient with TTP who developed refractory disease aft er an initial response to PLEX. She was subsequently treated with cycl osporine A and showed an immediate and sustained response. CSA may be a safe and effective therapy for patients with refractory TTP and shou ld be studied in randomized, prospective clinical trials.