Predictors of splenectomy response in patients with immune thrombocytopenia

OBJECTIVE To evaluate the predictors of the response to splenectomy in patients with immune thrombocytopenia. METHOD The medical records were reviewed retrospectively of patients who had undergone total splenectomy for immune thrombocytopenia at a tertiary center between January 2009 and December 2019. RESULTS This study included 40 patients (28 females and 12 males) with immune thrombocytopenia. A complete response was obtained in 31 (77.5%) patients, with 9 (22.5%) patients failing to respond to splenectomy. The response was stable in 25 patients (62.5%), and 5 patients (12.5%) had a recurrence. The postoperative mortality rate was 2.5%; one patient developed an ischemic stroke and died. Multivariate analysis demonstrated that an extended time from diagnosis to splenectomy, a lower demand for transfusion of blood components, and a shorter length of hospitalization were positively associated with a complete response. CONCLUSIONS Splenectomy should be considered as the therapeutic approach to immune thrombocytopenia, with a high curative potential in suitable patients. An extended time from diagnosis to splenectomy, lower demand for transfusion of blood components, and shorter length of hospitalization were found to be positively associated with a complete response after splenectomy.