title: Long-term relapse-free rurvival rate and predictive factors of idiopathic thrombocytopenic purpura in adults undergoing splenectomy.
abstract: BACKGROUND
  Our aim is to identify the long-term relapse-free rate and predictive factors of response to splenectomy in adults with idiopathic thrombocytopenic purpura (ITP).
  
  
  METHODS
  Between 1999 and 2005, 54 patients of ITP, who underwent splenectomy in Chang Gung Memorial Hospital, Linkou, Taiwan were retrospectively reviewed. Various pre, intra and postoperative factors were analyzed to determine the predictive factors of response and long-term disease-free rate after splenectomy in adult patients.
  
  
  RESULTS
  The relapse free survival rates in complete response patients of splenectomy at 1-, 3- and 5-yr are 91.9%, 88.4%, and 88.4%, respectively. Younger age, response to steroids, pre- and postsplenectomy high platelet counts were found to be have significant p value of < 0.05 as predictive factors in univariate analysis. In multivariate analysis, only pre-op and post-op platelet counts were significant.
  
  
  CONCLUSIONS
  Significant long-term relapse-free survival rate is achieved by splenectomy in adults with ITP. In univariate analysis, age, response to steroids, pre- and postsplenectomy platelet counts were the significant predictive factors of response. But in multivariate analysis, only pre-op and post-op platelet counts were significant.
authors.affiliation: Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Erh-Hao
authors.initials: EH
authors.lastname: Liu
authors.forename: Chakravarty K
authors.initials: CK
authors.lastname: Dilip
authors.forename: Ta-Sen
authors.initials: TS
authors.lastname: Yeh
authors.forename: Jin-Hou
authors.initials: JH
authors.lastname: Wu
authors.forename: Yi-Yin
authors.initials: YY
authors.lastname: Jan
authors.forename: Miin-Fu
authors.initials: MF
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count / Q000379:methods; D011183:Postoperative Complications / Q000601:surgery; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011379:Prognosis; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000401:mortality* / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013156:Splenectomy; D013624:Taiwan