Splenectomy as a curative treatment for immune thrombocytopenia: A retrospective analysis of 233 patients with a minimum follow up of 10 years
| Autor: | Joel Joelsson, Roberto Stasi, Nicola Polverelli, Eva Johansson, Silvia Cantoni, Marco Ruggeri, Michele Baccarani, Nicola Vianelli, Magnus Björkholm, Francesca Palandri, Enrica Morra, Anna Candoni, Francesco Zaja, Francesco Rodeghiero, Angelo Emanuele Catucci |
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| Přispěvatelé: | Vianelli N, Palandri F, Polverelli N, Stasi R, Joelsson J, Johansson E, Ruggeri M, Zaja F, Cantoni S, Catucci AE, Candoni A, Morra E, Björkholm M, Baccarani M, Rodeghiero F, Vianelli, N, Palandri, F, Polverelli, N, Stasi, R, Joelsson, J, Johansson, E, Ruggeri, M, Zaja, Francesco, Cantoni, S, Kolade, S, Candoni, A, Morra, E, Bjorkholm, M, Rodeghiero, F, Baccarani, M. |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Prognosi medicine.medical_treatment Splenectomy Thrombopoietin mimetics Follow-Up Studie Young Adult Postoperative Complications Retrospective Studie Retrospective analysis Humans Medicine Young adult Child Retrospective Studies Aged Purpura Thrombocytopenic Idiopathic business.industry Incidence (epidemiology) Incidence Infant Retrospective cohort study Hematology Middle Aged Prognosis medicine.disease Thrombosis Immune thrombocytopenia Surgery Treatment Outcome immune thrombocytopenia Child Preschool Female Postoperative Complication Original Articles and Brief Reports business Follow-Up Studies Human |
| Popis: | Background. The treatment of choice in steroid-resistant ITP is still controversial, due to the recent advent of new drugs (anti-CD20 and thrombopoietin mimetics) which have encouraged a generalized tendency to delay splenectomy. Consequently, the importance to define the efficacy and safety of splenectomy in the long-term is substantial. Patients and Methods. We retrospectively analyzed the data of 233 ITP patients who underwent splenectomy between 1959 and 2001, in 6 different European hematological Institutions and have now a minimum follow-up of 10 years from surgery. Results. Of the 233 patients, 206 (88%) achieved a response (87% complete). Sixty-eight out of 206 (33%) responsive patients relapsed, mostly (75%) within 4 years from first response. In 92 patients (39.5%), further treatment was required after splenectomy, which was effective in 76 cases (83%). In 138 patients (59%) response was maintained, free of any treatment, at last contact. No significant association between baseline characteristics and likelihood of stable response was found. Overall, 73 (31%) and 58 (25%) patients experienced at least one infectious or hemorrhagic complication. A stable response to splenectomy was associated with a lower rate of infectious (p=0.004) and hemorrhages (p |
| Databáze: | OpenAIRE |
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