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Long‐term results of splenectomy in adult chronic immune thrombocytopenia
Author(s) -
Guan Yue,
Wang Shixuan,
Xue Feng,
Liu Xiaofan,
Zhang Lei,
Li Huiyuan,
Yang Renchi
Publication year - 2017
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12821
Subject(s) - splenectomy , medicine , corticosteroid , refractory (planetary science) , platelet , complication , thrombosis , surgery , univariate analysis , gastroenterology , immune thrombocytopenia , multivariate analysis , spleen , physics , astrobiology
Objectives We performed this study in adult patients with chronic primary immune thrombocytopenia to explore the long‐term efficacy and safety of splenectomy. Methods Data of 174 patients who underwent splenectomy in our hospital from 1994 to 2014 were analyzed. Results After splenectomy, 126 (72.4%) patients achieved a complete response ( CR ) and 28 (16.1%) achieved a response (R). Thirty‐two (20.8%) responders relapsed with a median time of 24 months. Compared with non‐responders and recurrent patients, the stable responders were younger and had higher preoperation and postoperation peak platelet count, later peak platelet count emergence time, and more megakaryocytes. Corticosteroid‐dependent patients were more likely to response to splenectomy than those refractory to corticosteroid. We performed a relapse‐free survival analysis among the 154 responders. In univariate analyses, corticosteroid dependent and time from diagnosis to splenectomy ≤24 months showed predictive value to persistent response. But only corticosteroid dependent was a significant predictor in multivariate analysis. The 30‐d complication rate after the surgery was 25.9%. There were five (2.9%) patients experienced thrombosis and three (1.7%) refractory patients died during follow‐up. Conclusions Splenectomy was a safe treatment with a cure rate of 58.0%. Corticosteroid dependent showed predictive value to persistent response.