Prediction of response to splenectomy in patients with idiopathic thrombocytopenic purpura.
BACKGROUND
Chronic immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by destruction of opsonized platelets in the reticuloendothelial system, particularly the spleen, and by resulting low platelet counts. Splenectomy is the standard second-line treatment for patients with ITP who do not respond to corticosteroids. In the present study we determined predictive factors for the response of patients with ITP to splenectomy.


METHODS
For thirty-one patients with ITP referred from the Hematology Department of Shariati Hospital, open surgical splenectomy was performed between February 2002 and December 2004. All potentially important variables of response were collected and analyzed to determine predictive parameters.


RESULTS
Older patients (>52) responded less positively than younger patients (<52) to splenectomy (p<0.01). Likewise, patients with a sustained remission after splenectomy had a significantly shorter interval of diagnosis of ITP to splenectomy (p<0.05) and shorter duration of corticosteroid therapy before splenectomy (p<0.05).


CONCLUSIONS
This study confirms that splenectomy is an effective treatment for patients with ITP. Our findings highlight age as the major predictive factor of long-term response to splenectomy in patients with ITP.
Shojaiefard
A
A
Department of Surgery, Shariati Hospital, School of Medicine, Medical Sciences/University of Tehran, Kargar Shomali Avenue, Tehran, Iran. shojaief@sina.tums.ac.ir
Mousavi
S A
SA
Faghihi
S H
SH
Abdollahzade
S
S
D000328:Adult; D000367:Age Factors; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010976:Platelet Count; D011379:Prognosis; D011446:Prospective Studies; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery*; D055502:Secondary Prevention; D013156:Splenectomy / Q000379:methods*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome