Hematology

New Biomarkers Identified for Immune-Mediated TTP

New study data have pinpointed several biomarkers of outcomes in patients with immune-mediated thrombotic thrombocytopenic purpura, which “may help to stratify patients for more intensive management,” wrote the authors of the study.

 

These findings mark important progress in researchers’ understanding of immune-mediated thrombotic thrombocytopenic purpura, as reliable biomarkers predictive of outcomes among patients with the condition had not previously been identified.

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For their study, the researchers evaluated 73 unique patients with a confirmed diagnosis of immune-mediated thrombotic thrombocytopenic purpura between April 2006 and December 2017 at the University of Alabama Birmingham Medical Center.

 

During the study, clinical information, laboratory values, and a panel of special biomarkers were obtained.

 

Findings from the study revealed that patients with acute immune-mediated thrombotic thrombocytopenic purpura had elevated levels of the following biomarkers compared with healthy controls without a hematological disease:

 

  • Biomarkers associated with endothelial injury
    • von Willebrand factor antigen
    • Collagen-binding activity
  • Biomarkers associated with acute inflammation
    • Human neutrophil peptides 1 to 3
    • Histone/deoxyribonucleic acid complexes
  • Biomarkers associated with activation of the complement alternative pathway
    • Factor Bb
    • Factor iC3b

 

In addition, the following factors were predictive of mortality:

 

  • Failure to normalize platelet counts within 7 days
  • Failure to markedly lower serum lactate dehydrogenase by day 5
  • Low total serum protein or albumin
  • High serum troponin levels
  • Prolonged activated partial thromboplastin time
  • High fibrinogen
  • Elevated serum lactate dehydrogenase, Bb, and sC5b-9 upon admission

 

Along with helping identify patients in need of more intensive management, “[these] findings may also provide a framework for future multicenter studies to identify valuable prognostic markers for immune-mediated thrombotic thrombocytopenic purpura,” the researchers wrote.

 

—Christina Vogt

 

Reference:

Staley EM, Cao W, Pham HP, et al. Clinical factors and biomarkers predicting outcome in patients with immune-mediated thrombotic thrombocytopenic purpura. Hematologica. 2018;103(9). doi:10.3324/haematol.2018.198275