OUTCOME OF SPLENECTOMY IN THE TREATMENT OF ITP – ONE CENTER EXPERIENCE

Abstract

Objective: Immune thrombocytopenia (ITP) is a disease with variable clinical presentation, requiring different treatment lines. Splenectomy is used as a second- or third-line therapy for ITP. The aim of our study was to evaluate the outcome of splenectomy in the treatment of ITP in our center. Methodology: The study included 245 patients aged 18 years and older, diagnosed with ITP, treated at the Department of Haematology of the Jagiellonian University Hospital in Krakow from January 2006 to January 2021. Outcomes of splenectomy were analyzed. Results: 14.3%of all ITP patients underwent splenectomy, including 51.5% of those who needed second-line treatment. As much as 60% of them underwent surgery immediately after first-line treatment, while the rest was fist subjected to second-line pharmacological treatment. The mean time from ITP diagnosis to splenectomy was 31.9 months. The mean value of PLT count at the day of splenectomy was 57.4 × 109/L. The initial response rate was 74.3% and post-splenectomy relapses occurred in 22.9% of cases. Conclusion: In our center splenectomy was performed in more than half of the patients within the second-line treatment and resulted in permanent remission of the disease in 50% of cases. It is still a considerable method of ITP treatment, however its frequency decreases over time due to introduction and wider availability of thrombopoietin receptor agonists.