期刊
BRITISH JOURNAL OF HAEMATOLOGY
卷 112, 期 3, 页码 637-640出版社
BLACKWELL SCIENCE LTD
DOI: 10.1046/j.1365-2141.2001.02615.x
关键词
immune thrombocytopenia; splenectomy; predictive factors; age; IVGG
类别
Sixty-one consecutive patients undergoing splenectomy for chronic immune thrombocytopenia were retrospectively evaluated. Platelet response was considered as complete (CR) when platelet count rose to > 100 x 10(9)/ 1, partial (PR) when 30-100 x 10(9)/l or absent (NR) if otherwise. Follow-up (mean time 7.6 years) was possible in 54 patients. Forty-eight patients (88%) had an immediate response to splenectomy (39 CR, 9 PR) whereas six (12%) were NR. Thirty-six responders (67%) had sustained remission (31 CR, 5 PR) without further treatment; thrombocytopenia recurred in 12 patients (33%). The probability curve of continued remission showed a constant relapse-rate during the first 36 months; a further step of relapse was observed beginning 70 months after surgery. The only positive predictive factor for the long-term response to splenectomy was age <40 (P < 0.005). Neither duration of thrombocytopenia nor previous response to medical treatment (steroids and/or intravenous immunoglobulins) were related to splenectomy response.
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