Splenectomy for adult chronic idiopathic thrombocytopenic purpura: experience from a single center in China.

OBJECTIVES

The aim of this study was to explore the results of Chinese chronic idiopathic thrombocytopenic purpura (ITP) patients who underwent splenectomy (SE).

SUBJECTS AND METHODS

Data of 149 chronic ITP patients were retrospectively analyzed. Relapse-free survival was estimated by Kaplan-Meier analysis. Differences between responders and non-responders were evaluated using the chi-square.

RESULTS

The immediate response rate was 82.6% and the sustained response rate was 63.1%. Twenty-nine patients (19.5%) relapsed during follow-up. The 5-year actuarial relapse-free survival was about 75%. The overall morbidity was 26.1% and mortality was 2.7%. Patients with higher postsplenectomy peak platelet count, shorter time from diagnosis to SE and previous response to IVIG therapy were more likely to have sustained response to SE.

CONCLUSION

SE is potentially a useful therapy to provide long-term control of disease in adults with chronic ITP and is associated with low morbidity and mortality. Postsplenectomy peak platelet count, time from diagnosis to SE and previous response to intravenous immune globulin therapy appear predictive for response to SE.