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Splenectomy of Immune Thrombocytopenic Purpura in the Era of New Medical Therapies: A Retrospective Cohort Study from a Tertiary Cancer Center in Egypt

Abstract

Purpose of the study

Splenectomy is considered generally as a second-line therapy in refractory ITP patients and in relapsed patients after an initial response to medical treatment. About 80% of the patients respond adequately to splenectomy, with long-term remission in 66% without the need for any further treatment.

Patients and Methods

This retrospective cohort study was done in Oncology Center, Mansoura University, Egypt and included patients with refractory ITP to medical therapies between 2004 and 2021 with the assessment of their response rate after splenectomy and its surgical and hematological outcomes.

Results

Seventy-five patients with refractory ITP underwent splenectomy, 48 patients underwent open splenectomy and 27 patients underwent laparoscopic splenectomy. Forty-three patients had complete response (CR), eight patients had partial response (PR), and twenty-three patients had non- response (NR). About 88.4% of patients with achieved CR have maintained their response throughout the follow-up period and 9.8% of the patients had a relapsed disease. The median duration to loss of response after surgery was 23 months (range: 5–58 months).

Conclusion

Splenectomy, especially the laparoscopic approach, is a safe and effective line of treatment for refractory ITP patients, despite newer lines of therapy have been evolved and becoming more widely used in recent years.

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Data Availability

Are available from the corresponding author on reasonable request.

Code Availability

Not applicable.

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Acknowledgements

The authors of this study are grateful to their colleagues and patients in Oncology Center, Mansoura University.

Funding

Not applicable.

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Authors

Contributions

All authors have made substantial contributions to formal analysis, writing and editing of this manuscript. All authors have approved the submitted version of the article.

Corresponding author

Correspondence to Amr Abouzid.

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Conflict of interest

The authors declare no conflict of interest.

Ethical Approval

An approval was obtained from the Institutional Research Board (IRB) of the Faculty of Medicine, Mansoura University code (R.20.12.89).

Consent to Participate

A written informed consent was obtained from all the patients included in this study.

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Not applicable.

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This article is part of the Topical collection on Surgical Oncology.

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Abouzid, A., Setit, A., El-Ashwah, S. et al. Splenectomy of Immune Thrombocytopenic Purpura in the Era of New Medical Therapies: A Retrospective Cohort Study from a Tertiary Cancer Center in Egypt. Curr Surg Rep 10, 95–102 (2022). https://doi.org/10.1007/s40137-022-00316-x

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Keywords

  • Immune thrombocytopenic purpura
  • Splenectomy
  • Response rate
  • New medical therapies