Factors Predicting Response to Splenectomy in Patient with Immune Thrombocytopenia Purpura

ABSTRACT

OBJECTIVE: Splenectomy has been proposed to be the standard therapy for patients with steroid refractory immune thrombocytopenic purpura (ITP). This study aimed to describe valuable factors predicting the effect of splenectomy in patients with ITP. METHODS: A total of 51 adult patients who underwent splenectomy for steroid refractory ITP were evaluated their medical records retrospectively. The response to the treatment was classified on the basis of the platelet count. RESULTS: The responding group included 35 patients (68.8%), the partial-responding group included 4 patients (7.8%), and non-responding group was 12 patients (23.5%). On univariate analysis, the response of splenectomy correlated with only the intravenous immune globulin (IVIG) response (66.7%, P=0.006), but hemolysis, autoantibody, a presence of accessory spleen, the response of steroid were not significantly associated with the effect of splenectomy. On multivariate analysis, the response of IVIG and the amount of platelet transfusion were independent variables of the response of splenectomy. CONCLUSION: Patients with ITP who have good responses to IVIG are likely to have a good or favorable responses to splenectomy.