Use of Rituximab Treatment in Addition to Standard Care for Newly Presenting Thrombotic Thrombocytopenic Purpura

Exclusion Criteria

• •Patients will be excluded from the trial based on the following criteria:
• •A diagnosis of AIDS. Patients with HIV infection with absolute CD4 counts \>200/ul and no active, significant opportunistic infection are eligible
• •Patients with a known hepatitis C infection (HCV) and/or with hepatitis B
• •Patients receiving pheresis more than once a day
• •Recent (within 1 year) bone marrow or hematopoietic stem cell transplant
• •Patient is on calcineurin inhibitors, or is unable to come off them
• •Acute or chronic disseminated intravascular coagulation (DIC), defined by D-dimers \>8mg/ml and fibrinogen \< 100 mg (0.1g)/dl
• •A diagnosis of metastatic or non-metastatic malignancy other than basal cell carcinoma.
• •Malignant hypertension (systolic blood pressure \[BP\] \> 200 mm Hg or a diastolic BP \> 130 mm Hg)
• •Pregnancy (a negative serum pregnancy test should be performed for all women of childbearing potential within 7 days of treatment). Eligibility resumes 3 days after delivery
• •Patients with family history of or a previous diagnosis of congenital TTP
• •Patients with hemolytic uremic syndrome (HUS)
• •Patients with sepsis