Absolute lymphocyte count is a predictor of outcome after splenectomy for immune thrombocytopenia

Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased thrombocyte destruction and impaired thrombocyte production which can lead to isolated thrombocytopenia and spontaneous (1). The incidence of primary ITP in adults ranges between 1.6 and 3.9/100.000 people/year (2). With the development of new drugs such as thrombopoietin receptor agonists, splenectomy remains the second-line treatment for ITP patients unresponsive to corticosteroids (1,3,4). The cure rate of splenectomy has been reported to be higher than that of other treatments, at 60-70% in 5 years (5). In addition, no clear international guidelines for the order of treatment of ITP have been proposed and the selection of treatment has been seen to be based on physician and patient preference rather than on the evidence of clinical experience (6). The criteria and parameters that can predict response to splenectomy and prognosis are currently of great interest to researchers. The most frequently studied predictive and prognostic factors in splenectomy are age, the response to steroid treatment before splenectomy, the time from diagnosis to splenectomy (duration of disease), and pre-postoperative platelet count. There are conflicting results in different studies and no factor has been determined to consistently predict the DOI: 10.4274/gulhane.galenos.2019.855 ORIGINAL ARTICLE