|
|
Blood, 1 November 2004, Vol. 104, No. 9, pp. 2623-2634.
Prepublished online as a Blood First Edition Paper on June 24, 2004; DOI 10.1182/blood-2004-03-1168.
 Previous Article | Table of Contents | Next Article 
REVIEW ARTICLES
Splenectomy for adult patients with idiopathic thrombocytopenic purpura: a systematic review to assess long-term platelet count responses, prediction of response, and surgical complications
Kiarash Kojouri,
Sara K. Vesely,
Deirdra R. Terrell, and
James N. George
From the Hematology-Oncology Section, Department of Medicine, College of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City; and the Department of Biostatistics and Epidemiology, College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma City.
Splenectomy has been a standard treatment for adult patients with idiopathic thrombocytopenic purpura (ITP) for more than 50 years. However, the durability of responses, the ability to predict who will respond, and the frequency of surgical complications with splenectomy all remain uncertain. To better interpret current knowledge we systematically identified and reviewed all 135 case series, 1966 to 2004, that described 15 or more consecutive patients who had splenectomy for ITP and that had data for 1 of these 3 outcomes. Complete response was defined as a normal platelet count following splenectomy and for the duration of follow-up with no additional treatment. Forty-seven case series reported complete response in 1731 (66%) of 2623 adult patients with follow-up for 1 to 153 months; complete response rates did not correlate with duration of follow-up (r = -0.103, P = .49). None of 12 preoperative characteristics that have been reported consistently predicted response to splenectomy. Mortality was 1.0% (48 of 4955 patients) with laparotomy and 0.2% (3 of 1301 patients) with laparoscopy. Complication rates were 12.9% (318 of 2465) with laparotomy and 9.6% (88 of 921 patients) with laparoscopic splenectomy. Although the risk of surgery is an important consideration, splenectomy provides a high frequency of durable responses for adult patients with ITP. (Blood. 2004; 104:2623-2634)
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
M. Ruggeri, S. Fortuna, and F. Rodeghiero
Heterogeneity of terminology and clinical definitions in adult idiopathic thrombocytopenic purpura: a critical appraisal from a systematic review of the literature
Haematologica,
January 1, 2008;
93(1):
98 - 103.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Berentsen
Rituximab for the treatment of autoimmune cytopenias
Haematologica,
December 1, 2007;
92(12):
1589 - 1596.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. M. Boruchov, S. Gururangan, M. C. Driscoll, and J. B. Bussel
Multiagent induction and maintenance therapy for patients with refractory immune thrombocytopenic purpura (ITP)
Blood,
November 15, 2007;
110(10):
3526 - 3531.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. B. Cines and J. B. Bussel
How I treat idiopathic thrombocytopenic purpura (ITP)
Blood,
October 1, 2005;
106(7):
2244 - 2251.
[Full Text]
[PDF]
|
|
|
| |
