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Long-term outcomes of a 5-year follow up of patients with immune thrombocytopenic purpura after splenectomy.

Han JJ, Baek SK, Lee JJ, Kim SY, Cho KS, Yoon HJ - Korean J Hematol (2010)

Bottom Line: However, the response rate at 6 and 12 months decreased to 77% and 68%, respectively.After a median follow-up of 7 years (range: 1-25 years) from the diagnosis, there were 2 deaths, including one due to spontaneous bleeding after repair of duodenal ulcer perforation.The duration of response is different between the patients that achieved CR and those that achieved PR.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology-Oncology, School of Medicine, Kyung Hee University, Seoul, Korea.

ABSTRACT

Background: The long-term outcomes of adult patients with immune thrombocytopenic purpura (ITP) after splenectomy are not clear.

Methods: We retrospectively analyzed 31 patients who underwent splenectomy after diagnosis of ITP at our institution between 1990 and 2009. Long-term follow-up was defined as a follow-up that lasted 1 year or more from splenectomy to the last follow-up.

Results: The overall response rate to splenectomy was 84%. However, the response rate at 6 and 12 months decreased to 77% and 68%, respectively. During the 6 years of median follow-up after splenectomy, 11 patients (35%) relapsed. The long-term response rate was 55%. The long-term follow-up of 26 patients after responding to splenectomy showed that the median time from splenectomy to relapse was 19 months in the partial response (PR) group; however, there was no relapse after 9 months in the complete response (CR) group. Variables, including age, were not predictive of the long-term response after splenectomy. Additional treatment in patients who did not respond or relapsed after splenectomy was mostly effective. After a median follow-up of 7 years (range: 1-25 years) from the diagnosis, there were 2 deaths, including one due to spontaneous bleeding after repair of duodenal ulcer perforation.

Conclusion: Although splenectomy is safe and effective, the response rate after splenectomy continuously decreases over time. The duration of response is different between the patients that achieved CR and those that achieved PR. Factors, including age, were not predictors of a response to splenectomy.

No MeSH data available.


Related in: MedlinePlus

Progression-free survival of all 31 patients after splenectomy. Median time of progression-free survival was 70 months.
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Figure 1: Progression-free survival of all 31 patients after splenectomy. Median time of progression-free survival was 70 months.

Mentions: The overall response rate to splenectomy was 84% with CR in 14 and PR in 12. The response rate at 6 and 12 months was 77% and 68%, respectively. The long-term response rate to splenectomy was 55%. Of the remaining patients, 35% relapsed and 10% were non-responders (Table 3). Nine patients relapsed within 24 months after splenectomy and 2 patients relapsed at 70 and 104 months. The median time for the progression of survival after splenectomy was 70 months (Fig. 1). In the 26 patients that responded to splenectomy, the curve of the proportion of patients remaining in remission plateaued after 9 months in the CR group; however, this rate continuously decreased in the PR group, in which the median time between splenectomy and relapse was 19 months (Fig. 2).


Long-term outcomes of a 5-year follow up of patients with immune thrombocytopenic purpura after splenectomy.

Han JJ, Baek SK, Lee JJ, Kim SY, Cho KS, Yoon HJ - Korean J Hematol (2010)

Progression-free survival of all 31 patients after splenectomy. Median time of progression-free survival was 70 months.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2983037&req=5

Figure 1: Progression-free survival of all 31 patients after splenectomy. Median time of progression-free survival was 70 months.
Mentions: The overall response rate to splenectomy was 84% with CR in 14 and PR in 12. The response rate at 6 and 12 months was 77% and 68%, respectively. The long-term response rate to splenectomy was 55%. Of the remaining patients, 35% relapsed and 10% were non-responders (Table 3). Nine patients relapsed within 24 months after splenectomy and 2 patients relapsed at 70 and 104 months. The median time for the progression of survival after splenectomy was 70 months (Fig. 1). In the 26 patients that responded to splenectomy, the curve of the proportion of patients remaining in remission plateaued after 9 months in the CR group; however, this rate continuously decreased in the PR group, in which the median time between splenectomy and relapse was 19 months (Fig. 2).

Bottom Line: However, the response rate at 6 and 12 months decreased to 77% and 68%, respectively.After a median follow-up of 7 years (range: 1-25 years) from the diagnosis, there were 2 deaths, including one due to spontaneous bleeding after repair of duodenal ulcer perforation.The duration of response is different between the patients that achieved CR and those that achieved PR.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology-Oncology, School of Medicine, Kyung Hee University, Seoul, Korea.

ABSTRACT

Background: The long-term outcomes of adult patients with immune thrombocytopenic purpura (ITP) after splenectomy are not clear.

Methods: We retrospectively analyzed 31 patients who underwent splenectomy after diagnosis of ITP at our institution between 1990 and 2009. Long-term follow-up was defined as a follow-up that lasted 1 year or more from splenectomy to the last follow-up.

Results: The overall response rate to splenectomy was 84%. However, the response rate at 6 and 12 months decreased to 77% and 68%, respectively. During the 6 years of median follow-up after splenectomy, 11 patients (35%) relapsed. The long-term response rate was 55%. The long-term follow-up of 26 patients after responding to splenectomy showed that the median time from splenectomy to relapse was 19 months in the partial response (PR) group; however, there was no relapse after 9 months in the complete response (CR) group. Variables, including age, were not predictive of the long-term response after splenectomy. Additional treatment in patients who did not respond or relapsed after splenectomy was mostly effective. After a median follow-up of 7 years (range: 1-25 years) from the diagnosis, there were 2 deaths, including one due to spontaneous bleeding after repair of duodenal ulcer perforation.

Conclusion: Although splenectomy is safe and effective, the response rate after splenectomy continuously decreases over time. The duration of response is different between the patients that achieved CR and those that achieved PR. Factors, including age, were not predictors of a response to splenectomy.

No MeSH data available.


Related in: MedlinePlus