Long term follow-up after splenectomy performed for immune thrombocytopenic purpura (ITP)
Article first published online: 28 JAN 2003
Copyright © 2003 Wiley-Liss, Inc.
American Journal of Hematology
Volume 72, Issue 2, pages 94–98, February 2003
How to Cite
Schwartz, J., Leber, M. D., Gillis, S., Giunta, A., Eldor, A. and Bussel, J. B. (2003), Long term follow-up after splenectomy performed for immune thrombocytopenic purpura (ITP). Am. J. Hematol., 72: 94–98. doi: 10.1002/ajh.10253
- Issue published online: 28 JAN 2003
- Article first published online: 28 JAN 2003
- Manuscript Accepted: 15 OCT 2002
- Manuscript Received: 16 MAY 2002
Splenectomy is the only treatment of ITP known to have “curative” effects in a substantial fraction of patients. However, the true long-term outcome is uncertain and controversial because published series have not adjusted for the duration of follow-up. This IRB-approved retrospective study included all patients with ITP who underwent splenectomy between 1988-1993 at three major medical centers and required a minimum postoperative 5-year follow-up. Complete response (CR) was defined as all postsplenectomy platelet counts >150 × 109/L without treatment; partial response (PR) as platelet counts ≥50 × 109/L without treatment; and failure as platelet counts <50 × 109/L or receiving therapy after splenectomy. Seventy-five patients identified with ITP underwent splenectomy from 1988 to 1993. Three patients died prior to 5-year follow-up, and 56 of the 72 patients (78%) were evaluable with follow-up for five years or longer, median 7.5 years. The immediate postoperative complete remission rate was 77%; 57% of patients have remained in prolonged CR. Thirty-seven patients (66%) have not required any therapy after splenectomy. Eight patients had platelet counts >150 × 109/L for 4–8.5 years before relapsing; no clear plateau was attained in the remission curve. There was no operative mortality. Ten patients (18%) reported minor postoperative bleeding episodes. No life-threatening infections, significant heart disease, or pulmonary hypertension developed after splenectomy in the 434 patient-years of follow-up. This study helps to define the long-term results of splenectomy for ITP. Am. J. Hematol. 72:94–98, 2003. © 2003 Wiley-Liss, Inc.