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Activated platelet aggregates in thrombotic thromboctyopenic purpura: decrease with plasma infusions and

Y S Ahn¹, W Jy, L Kolodny

¹William J. Harrington Center for Blood Diseases, Department of Medicine, University of Miami School of Medicine, Florida 33136, USA.

British Journal of Haematology

|November 1, 1996

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Activated platelet aggregates (aPA) are elevated in active thrombotic thrombocytopenic purpura (TTP) and normalize in remission. Flow cytometry assaying aPA is a sensitive indicator of TTP disease activity, preceding traditional markers.

Area of Science:

Hematology
Immunology
Thrombosis Research

Background:

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening thrombotic microangiopathy.
Current diagnostic markers for TTP lack sensitivity in early disease detection.

Purpose of the Study:

To evaluate circulating activated platelet aggregates (aPA) as a sensitive biomarker for TTP activity.
To compare the sensitivity of flow cytometry assay for aPA versus platelet aggregometry.

Main Methods:

Flow cytometry using anti-CD62p monoclonal antibody to quantify aPA in TTP patients.
Assay of plasma from TTP patients for aPA-promoting activity.
Comparison with platelet aggregometry.

Main Results:

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All active TTP patients showed elevated aPA, which normalized during remission.
aPA levels changed preceding traditional TTP indicators (LDH, hematocrit, platelet count).
TTP plasma induced significantly greater aPA formation in normal blood compared to ITP plasma controls.

Conclusions:

Circulating activated platelet aggregates (aPA) are a sensitive marker of TTP disease activity.
Flow cytometry assay for aPA is more sensitive than aggregometry in detecting TTP-related platelet activation.
aPA monitoring can aid in early detection of TTP relapses and treatment response.