Splenectomy in Patients with Chronic Idiopathic Thrombocytopenic Purpura

Splenectomy considered as second line therapy in management of patients with idiopathic thrombocytopenic purpura (ITP) whom did not respond to corticosteroid or the platelet decreased after corticosteroid cessation. The aim of the present study was to determine the response to splenectomy in chronic ITP patients. This retrospective cohort study was performed on all patients with ITP who underwent splenectomy at Shahid Beheshti and Yahyanejad hospitals during 10 years. Age، sex، time of initial treatment، time of surgery، platelet counts at time of diagnosis، pre- and post-operative platelet counts، respond to treatment and receiving treatment، extracted from the patient''s registry. From 41 patients، the immediate postoperative response was partial in 4 patients (9. 8%) and complete in 37 patients (90. 2%). Non-response was not seen in any patient. The median follow-up was 12 months (range: 1-101 months). In long-term follow up، complete response (CR) was achieved in 4 patients (85. 3%) and partial response was achieved in 2 (%4. 9) of patients and treatment failure was achieved in 4 patients (9. 8%). According to the results of this study، many of patients with ITP who underwent splenectomy have long term remission and splenectomy is a safe and effective method of treatment for these patients.