Splenectomy done during hematologic remission to prevent relapse in patients with thrombotic thrombocytopenic purpura.

Abstract

OBJECTIVE:

To assess whether splenectomy done during hematologic remission reduces the relapse rate in patients with relapsing thrombotic thrombocytopenic purpura.

DESIGN:

Consecutive case series.

SETTING:

Tertiary care teaching hospital.

PATIENTS:

6 consecutive patients seen during a 10-year period who had had one or more relapses of thrombotic thrombocytopenic purpura.

INTERVENTIONS:

All patients had elective splenectomy while in hematologic remission and were followed after surgery for as long as 8.0 years.

MEASUREMENTS:

Attack rates (events per year) were calculated for each patient from time of presentation to time of splenectomy and from time of splenectomy to January 1996.

RESULTS:

A total of 26 episodes of thrombotic thrombocytopenic purpura occurred over 22.3 patient-years before splenectomy. After splenectomy, 3 acute episodes occurred over 22.7 patient-years. The attack rate (+/-1 SD) decreased from 2.3 +/- 2.0 events per year to 0.1 +/- 0.1 events per year.

CONCLUSION:

In patients who have had one or more relapses of thrombotic thrombocytopenic purpura, splenectomy done during hematologic remission reduces the frequency of acute relapse and the resulting need for medical therapy.

• Authors: M A Crowther, N Heddle, C P Hayward, T Warkentin, J G Kelton
• Journal: Annals of internal medicine (Ann Intern Med) Vol. 125 Issue 4 Pg. 294-6 (Aug 15 1996) ISSN: 0003-4819 [Print] United States
• PMID: 8678392 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Humans
• Purpura, Thrombotic Thrombocytopenic (prevention & control)
• Recurrence
• Splenectomy
• Treatment Outcome