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We think that the use of vincristine alone is justified since, in our opinion, treatment of TTP continues to be experimental. It did not jeopardize our patients, although this was learned in retrospect. We do not agree with the therapeutic approach suggested by Drs Gundlach and Tarnasky, since it would only perpetuate the current state of controversy and uncertainty about therapy for TTP. Instead, a well-designed clinical trial is needed to clarify the role of the various therapeutic measures.
Gutterman LA, Stevenson TD. Thrombotic Thrombocytopenic Purpura and Vincristine-Reply. JAMA. 1982;248(9):1063. doi:10.1001/jama.1982.03330090035014