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Splenectomy during partial remission in thrombotic thrombocytopenic purpura with prolonged plasma exchange dependency
Author(s) -
Mant Michael J.,
Turner A. Robert,
Bruce D.,
Ritchie C.,
Larratt Loree M.
Publication year - 1999
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/(sici)1096-8652(199909)62:1<56::aid-ajh10>3.0.co;2-5
Subject(s) - thrombotic thrombocytopenic purpura , splenectomy , medicine , gastroenterology , surgery , platelet , spleen
Some patients with thrombotic thrombocytopenic purpura (TTP) remain plasma‐exchange‐dependent for prolonged periods of time. This exposes patients to risk, uses substantial resources, and requires prolonged hospitalization. We have splenectomized 7 such patients following 25–42 plasma exchanges while patients were in partial remission only and were clinically stable. In 6 patients, including 1 with TTP secondary to mitomycin C, thrombocytopenia promptly resolved. Relapse has not occurred during 18 or more months of observation. The seventh patient did not respond. We conclude that splenectomy should be considered as an alternative to continued plasma‐exchange therapy in such patients. Am. J. Hematol. 62:56–57, 1999. © 1999 Wiley‐Liss, Inc.