成人和儿童慢性持续性免疫性血小板减少症（ITP）脾切除术后的长期结局：ITP的脾切除术

Long-term outcome following splenectomy for chronic and persistent immune thrombocytopenia (ITP) in adults and children : Splenectomy in ITP.

作者信息

Ahmed Rayaz, Devasia Anup J, Viswabandya Auro, Lakshmi Kavitha M, Abraham Aby, Karl Sampath, Mathai John, Jacob Paul M, Abraham Deepak, Srivastava Alok, Mathews Vikram, George Biju

机构信息

Department of Haematology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India.

Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India.

出版信息

Ann Hematol. 2016 Sep;95(9):1429-34. doi: 10.1007/s00277-016-2738-3. Epub 2016 Jul 2.

DOI:10.1007/s00277-016-2738-3

PMID:27370992

Abstract

The purpose of this research is to study the outcomes of splenectomy for chronic and persistent immune thrombocytopenia (ITP). This study is a retrospective analysis of 254 patients with chronic or persistent ITP who underwent splenectomy at CMC, Vellore, India between 1995 and 2009. Responses were assessed based on standard criteria. One hundred and sixty seven adults and 87 children with a median age of 29 years (range 2-64) with persistent (n = 103) or chronic ITP (n = 151) was studied. Response was seen in 229 (90.2 %) including CR in 74.4 % at a median time of 1 day (range 1-54). Infections following splenectomy were reported in 16 %. Deaths related to post splenectomy sepsis occurred in 1.57 % and major bleeding in 0.78 %. At median follow-up of 54.3 months (range 1-290), 178 (70.1 %) remain in remission. The 5-year and 10-year overall survival (OS) is 97.4 ± 1.2 % and 94.9 ± 2.1 %, respectively, while the 5-year and 10-year event-free survival (EFS) is 76.5 + 2.9 % and 71.0 + 3.9 %, respectively. Splenectomy is associated with long-term remission rates of >70 % in chronic or persistent ITP.

摘要

本研究的目的是探讨慢性持续性免疫性血小板减少症（ITP）行脾切除术后的疗效。本研究对1995年至2009年间在印度韦洛尔基督教医学院接受脾切除术的254例慢性或持续性ITP患者进行了回顾性分析。根据标准标准评估疗效。研究对象为167例成人和87例儿童，中位年龄29岁（范围2 - 64岁），患有持续性ITP（n = 103）或慢性ITP（n = 151）。229例（90.2%）出现疗效，其中74.4%达到完全缓解，中位时间为1天（范围1 - 54天）。脾切除术后感染发生率为16%。脾切除术后败血症相关死亡率为1.57%，大出血发生率为0.78%。中位随访54.3个月（范围1 - 290个月），178例（70.1%）仍处于缓解状态。5年和10年总生存率（OS）分别为97.4±1.2%和94.9±2.1%，而5年和10年无事件生存率（EFS）分别为76.5 + 2.9%和71.0 + 3.9%。脾切除术与慢性或持续性ITP超过70%的长期缓解率相关。