5
Table 3. PLASMIC score or French score predicts the
likelihood of severe ADAMTS13 deficiency in a
suspected TTP
Parameters French Score PLASMIC Score
Platelet count <30 × 10
9
/L (+1) <30 × 10
9
/L (+1)
Serum creatinine level <2.26 mg/dL (+1) <2.0 mg/dL (+1)
Hemolysis
Indirect bilirubin >2 mg/dL * +1
or reticulocyte count >2.5 %
or undetectable haptoglobin
No active cancer in previous year * +1
No history of solid organ or SCT * +1
INR <1.5 * +1
MCV <90 f L NA +1
Likelihood of severe deficiency of
ADAMTS13 activity (<10 %) 0: 2% 0–4: 0–4%
1: 70% 6: 5–24%
2: 94% 6–7: 62–82%
Each item is associated with one point (+1).
*French score considered patients with thrombotic microangiopathy (TMA) that included hemolysis
and schistocytes in their definition and assumed that there was no history or clinical evidence for
associated cancer, transplantation or disseminated intravascular coagulation. erefore, these items
were intrinsic to the scoring system.
e table is adopted from Joly B.S. Expert Rev Hematol. 2019;12:383-95.
➤ In settings of no reasonable access to plasma ADAMTS13 testing,
the panel suggests that caplacizumab not be used, regardless of the
pretest probability of immune TTP. (C-L).
• TPE and steroids, plus rituximab may still be offered in the scenario.
