Episode 234: Oncologic Emergencies 101: Thrombotic Thrombocytopenia Purpura

“Once patients come out on the other side, nursing care involves understanding how to triage their disease: If they call you with concerns, how would you address those concerns? How would you find out if there’s something going on? Just given how acute the onset is, a lot of these patients have some post-traumatic stress disorder, so there’s a lot of worried-well conversations, and in outpatients you need to figure out how to coordinate future care given their history of thrombotic thrombocytopenia purpura (TTP),” ONS member Amanda Weatherford, MSN, RN, OCN®, clinical nurse coordinator at Fred Hutchinson Cancer Center in Seattle, WA, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS in a conversation about nursing considerations to manage TTP. This episode is part of a series about oncologic emergencies; the others are linked in the episode notes. You can earn free NCPD contact hours after listening to this episode by completing the evaluation linked below.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by November 18, 2024. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center’s Commission on Accreditation.

Upon completion of this activity, participants will report an increase in knowledge of thrombotic thrombocytopenia purpura.

Episode Notes

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.

Highlights From Today’s Episode

“Immune or acquired thrombotic thrombocytopenia purpura (TTP) is the most common. It’s 95% of all the cases. It is what we as nurses are most likely to encounter in our practice.” Timestamp (TS) 03:29

“TTP can show up in cancer and also as the result of chemotherapy and medications. They say it’s either a system of malignancy or a consequence of treatment, and it has also shown up in patients who are post allogenic stem cell transplants.” TS 07:05

“Once you suspect that TTP is into play, you would immediately start the patient on plasma exchange or plasma pheresis, daily or twice daily, and also on high-dose steroids. You do that until you start to see improvement in platelet counts and some of the other hemolysis markers, like LDH.” TS 11:26

“Once patients come out on the other side, nursing care involves understanding how to triage their disease: If they call you with concerns, how would you address those concerns? How would you find out if there’s something going on? Just given how acute the onset is, a lot of these patients have some post-traumatic stress disorder, so there’s a lot of worried-well conversations, and in outpatients you need to figure out how to coordinate future care given their history of TTP.” TS 14:58

“In patients with cancer, TTP is either a symptom of disease or caused by the treatment. So, you could potentially just have a new patient with cancer and, along with this major, acute crisis that they’ve had, so dealing with a cancer diagnosis and having had TTP. Or trying to figure out if it was medication. How do we resolve that? Are we able to find a different drug and switch to a different regiment, or do we continue to give it because it’s the only therapy? And do we have to continue to be on the lookout for relapse?” TS 17:47

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