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A 59-year-old woman, diagnosed with chronic myelogenous leukemia (chronic
phase) and treated with interferon-alpha for 13 years, developed renal failure.
Renal biopsy showed thrombotic thrombocytopenic purpura, but intensive therapy
including plasma exchange and steroid administration was not effective. The
activity of von Willebrand factor-cleaving protease was detectable at the
intermediate level (15-46%) during the clinical course, suggesting that this
case was not compatible with the previously reported pattern of idiopathic or
drug-induced thrombotic thrombocytopenic purpura, but with the pattern
associated with malignant disease or immunological disorders.
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