Splenomegaly and Response to Splenectomy in Immune Thrombocytopenia
Abstract
:1. Introduction
2. Methods
2.1. Patient Selection
2.2. Data Collection
2.3. Statistical Analysis
2.4. Institutional Review
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patients (n = 40) | |
---|---|
Median Age, years (Range) | 46.6 (19.6–92.6) |
Female n (%) | 25 (62.5) |
Race, n (%) | |
Hispanic | 16 (40) |
Black | 10 (25) |
White | 7 (17.5) |
Asian | 1 (2.5) |
Declined/Not specified | 6 (15) |
Clinical Characteristics, n (%) | |
Comorbid Autoimmune Condition | 14 (35) |
Antiphospholipid Syndrome | 2 (5) |
HCV/HIV | 3 (7.5) |
Preoperative Responsive to Therapies, n (%) | |
Steroids (n = 32) | 19 (59.4) |
IVIG (n = 18) | 13 (72.2) |
Steroids and IVIG (n = 30) | 24 (80) |
TPO (n = 11) | 8 (72.7) |
Rituximab (n = 12) | 5 (41.7) |
Danazol (n = 5) | 3 (60) |
Immunosuppressive (n = 1) | 1 (100) |
Preoperative Evaluation, n (%) | |
Abdominal imaging | 32 (80) |
CT | 19 (47.5) |
US | 12 (30) |
MRI | 1 (2.5) |
Bone marrow biopsy | 21 (52.5) |
Preoperative vaccination | 18 (45) |
Splenomegaly (n = 32) | 12 (37.5) |
Surgical Course, n (%) | |
Clavien–Dindo Grade Complications (>0) | 10 (25) |
Laparoscopic (vs. Open) | 38 (95) |
30-day mortality | 2 (5) |
PE | 2 (5) |
SMVT/PVT | 3 (7.5) |
Patients (n = 40) | |
---|---|
Platelet Count at 30 Days, n (%) | |
Complete response (CR) | 30 (75) |
Partial response (PR) | 2 (5) |
No response (NR) | 6 (15) |
Deceased at POD 30 | 2 (5) |
Response at Last Follow-Up by Platelet Count, n (%) | |
Complete response (CR) | 34 (85) |
Partial response (PR) | 3 (7.5) |
No response (NR) | 1 (2.5) |
Deceased at POD 30 | 2 (5) |
Response at Last Follow-Up by Treatment, n (%) | |
No further medical therapy | 24 (60) |
Off medical therapy for >1 year | 5 (12.5) |
On medical therapy | 9 (22.5) |
Deceased at POD 30 | 2 (5) |
Sustained Response p | |
---|---|
Demographic Data | |
Age (at time of splenectomy) | 0.034 |
Race | 0.24 |
Sex | 0.32 |
Preoperative Data | |
Platelets at diagnosis | 0.43 |
Platelets at nadir | 0.56 |
Splenomegaly | 0.018 |
Fewer prior therapies | 0.0065 |
Fewer relapses | 0.060 |
Responsive to steroids and IVIG | 0.51 |
Postoperative Data | |
Length of Stay | 0.19 |
Post-op platelet count (am next day) | 0.27 |
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Rabinovich, E.; Pradhan, K.; Islam, I.; Davido, H.T.; Gali, R.; Muscarella, P.; Billett, H.H. Splenomegaly and Response to Splenectomy in Immune Thrombocytopenia. J. Clin. Med. 2024, 13, 3712. https://doi.org/10.3390/jcm13133712
Rabinovich E, Pradhan K, Islam I, Davido HT, Gali R, Muscarella P, Billett HH. Splenomegaly and Response to Splenectomy in Immune Thrombocytopenia. Journal of Clinical Medicine. 2024; 13(13):3712. https://doi.org/10.3390/jcm13133712
Chicago/Turabian StyleRabinovich, Emma, Kith Pradhan, Iffath Islam, Helen Tracy Davido, Radhika Gali, Peter Muscarella, and Henny H. Billett. 2024. "Splenomegaly and Response to Splenectomy in Immune Thrombocytopenia" Journal of Clinical Medicine 13, no. 13: 3712. https://doi.org/10.3390/jcm13133712
APA StyleRabinovich, E., Pradhan, K., Islam, I., Davido, H. T., Gali, R., Muscarella, P., & Billett, H. H. (2024). Splenomegaly and Response to Splenectomy in Immune Thrombocytopenia. Journal of Clinical Medicine, 13(13), 3712. https://doi.org/10.3390/jcm13133712