Long term follow‐up after splenectomy performed for immune thrombocytopenic purpura (ITP)

Abstract

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 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.