title: Long-term outcome following splenectomy for chronic and persistent immune thrombocytopenia (ITP) in adults and children : Splenectomy in ITP.
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.
authors.affiliation: Department of Haematology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India.
authors.forename: Rayaz
authors.initials: R
authors.lastname: Ahmed
authors.affiliation: Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Anup J
authors.initials: AJ
authors.lastname: Devasia
authors.affiliation: Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Auro
authors.initials: A
authors.lastname: Viswabandya
authors.affiliation: Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Kavitha M
authors.initials: KM
authors.lastname: Lakshmi
authors.affiliation: Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Aby
authors.initials: A
authors.lastname: Abraham
authors.affiliation: Department of Paediatric Surgery, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Sampath
authors.initials: S
authors.lastname: Karl
authors.affiliation: Department of Paediatric Surgery, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: John
authors.initials: J
authors.lastname: Mathai
authors.affiliation: Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Jacob
authors.affiliation: Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Abraham
authors.affiliation: Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Alok
authors.initials: A
authors.lastname: Srivastava
authors.affiliation: Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Vikram
authors.initials: V
authors.lastname: Mathews
authors.affiliation: Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India. biju@cmcvellore.ac.in.
authors.forename: Biju
authors.initials: B
authors.lastname: George
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000209:etiology / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D016016:Proportional Hazards Models; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology / Q000401:mortality; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods*; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
keywords: ITP; Outcomes; Splenectomy