{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T18:22:28Z","timestamp":1787595748944,"version":"build-2736575974"},"reference-count":36,"publisher":"American Society of Hematology","issue":"12","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is characterized by recurring episodes of thrombotic microangiopathy, causing ischemic organ impairment. Black patients are overrepresented in iTTP cohorts in the United States, but racial disparities in iTTP outcome and response to therapy have not been studied. Using the United States Thrombotic Microangiopathies Consortium iTTP Registry, we evaluated the impact of race on mortality and relapse-free survival (RFS) in confirmed iTTP in the United States from 1995 to 2020. We separately examined the impact of rituximab therapy and presentation with newly diagnosed (de novo) or relapsed iTTP on RFS by race. A total of 645 participants with 1308 iTTP episodes were available for analysis. Acute iTTP mortality did not differ by race. When all episodes of iTTP were included, Black race was associated with shorter RFS (hazard ratio [HR], 1.60; 95% CI, 1.16-2.21); the addition of rituximab to corticosteroids improved RFS in White (HR, 0.37; 95% CI, 0.18-0.73) but not Black patients (HR, 0.96; 95% CI, 0.71-1.31). In de novo iTTP, rituximab delayed relapse, but Black patients had shorter RFS than White patients, regardless of treatment. In relapsed iTTP, rituximab significantly improved RFS in White but not Black patients. Race affects overall relapse risk and response to rituximab in iTTP. Black patients may require closer monitoring, earlier retreatment, and alternative immunosuppression after rituximab treatment. How race, racism, and social determinants of health contribute to the disparity in relapse risk in iTTP deserves further study.<\/jats:p>","DOI":"10.1182\/blood.2022016640","type":"journal-article","created":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T19:02:14Z","timestamp":1657220534000},"page":"1335-1344","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":43,"title":["Race, rituximab, and relapse in TTP"],"prefix":"10.1182","volume":"140","author":[{"given":"Shruti","family":"Chaturvedi","sequence":"first","affiliation":[{"name":"1Department of Medicine, Johns Hopkins University, Baltimore, MD;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana G.","family":"Antun","sequence":"additional","affiliation":[{"name":"2Department of Medicine, Emory University, Atlanta, GA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Farland","sequence":"additional","affiliation":[{"name":"3Department of Medicine, Wake Forest University, Winston-Salem, NC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Woods","sequence":"additional","affiliation":[{"name":"3Department of Medicine, Wake Forest University, Winston-Salem, NC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9890-8639","authenticated-orcid":false,"given":"Ara","family":"Metjian","sequence":"additional","affiliation":[{"name":"4Department of Medicine, University of Colorado, Denver, CO;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yara A.","family":"Park","sequence":"additional","affiliation":[{"name":"5Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustaaf","family":"de Ridder","sequence":"additional","affiliation":[{"name":"5Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC;"},{"name":"6Geisinger Medical Laboratories, Danville, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Briana","family":"Gibson","sequence":"additional","affiliation":[{"name":"5Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC;"},{"name":"7Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6672-3082","authenticated-orcid":false,"given":"Raj S.","family":"Kasthuri","sequence":"additional","affiliation":[{"name":"8Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darla K.","family":"Liles","sequence":"additional","affiliation":[{"name":"9Department of Medicine, East Carolina University, Greenville, NC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Akwaa","sequence":"additional","affiliation":[{"name":"10Department of Medicine, University of Rochester, Rochester, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Clover","sequence":"additional","affiliation":[{"name":"11St Charles Healthcare, Bend, OR;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1171-0548","authenticated-orcid":false,"given":"Lisa","family":"Baumann Kreuziger","sequence":"additional","affiliation":[{"name":"12Versiti Blood Research Institute, Milwaukee, WI;"},{"name":"13Department of Medicine, Medical College of Wisconsin, Milwaukee, WI;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Evan","family":"Sadler","sequence":"additional","affiliation":[{"name":"14Department of Medicine, Washington University, St Louis, MO;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7225-8228","authenticated-orcid":false,"given":"Meera","family":"Sridharan","sequence":"additional","affiliation":[{"name":"15Department of Medicine, Mayo Clinic, Rochester, MN;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald S.","family":"Go","sequence":"additional","affiliation":[{"name":"15Department of Medicine, Mayo Clinic, Rochester, MN;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7340-475X","authenticated-orcid":false,"given":"Keith R.","family":"McCrae","sequence":"additional","affiliation":[{"name":"16Department of Medicine, Cleveland Clinic, Cleveland, OH;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsh Vardhan","family":"Upreti","sequence":"additional","affiliation":[{"name":"1Department of Medicine, Johns Hopkins University, Baltimore, MD;"},{"name":"17Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Liu","sequence":"additional","affiliation":[{"name":"1Department of Medicine, Johns Hopkins University, Baltimore, MD;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5208-3387","authenticated-orcid":false,"given":"Ming Y.","family":"Lim","sequence":"additional","affiliation":[{"name":"18Department of Medicine, University of Utah, Salt Lake City, UT;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radhika","family":"Gangaraju","sequence":"additional","affiliation":[{"name":"19Department of Medicine, University of Alabama at Birmingham;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1680-5295","authenticated-orcid":false,"given":"X. 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