ArticleJournal of internal medicine2024
Splenectomy outcomes in immune cytopenias: Treatment outcomes and determinants of response.
Article in Journal of internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 8 citations in OpenAlex.
- Long-Term Outcomes of Rituximab Therapy in Autoimmune Hemolytic Anemia: A Systematic Review and Meta-Analysis.Cureus · 2025Review
- Eltrombopag for the treatment of refractory connective tissue disease-related thrombocytopenia: a pilot study of 52 cases.Arthritis research & therapy · 2025Observational
- Analytical cohort study on splenomegaly and cytopenias in myeloproliferative disorders.Bioinformation · 2025Article
- Case Report: Autoimmune hemolytic anemia associated with ovarian teratoma in a 13-year-old: a rare paraneoplastic presentation.Frontiers in pediatrics · 2025Article
- Article
- Severe, Refractory Primary Warm Autoimmune Hemolytic Anemia Requiring 90 Erythrocyte Transfusions.Annals of internal medicine. Clinical cases · 2024Article
- Autoimmune Hemolytic Anemias: Classifications, Pathophysiology, Diagnoses and Management.International journal of molecular sciences · 2024Review
- Splenectomy reappraised: Bridging the gap in immune cytopenia treatment paradigms.Journal of internal medicine · 2024Article
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundSplenectomy is commonly used to treat refractory immune-mediated cytopenia, but there are no established factors that are associated with response to the procedure.
objectivesA cohort study was conducted to evaluate the hematologic and surgical outcomes of splenectomy in adult patients with immune cytopenias and identify preoperative factors associated with response.
methodsData from the Cleveland Clinic Foundation for 1824 patients aged over 18 who underwent splenectomy from 2002 to 2020 were analyzed.
resultsThe study found that the most common indications for splenectomy were immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia, with a median age of 55 years and median time from diagnosis to splenectomy of 11 months. Hematologic response rates were 74% overall, with relapse in 12% of cases. Postsplenectomy discordant diagnoses were present in 13% of patients, associated with higher relapse rates. Surgery-related complications occurred in 12% of cases, whereas only 3% of patients died from disease complications. On univariate analysis, preoperative factors associated with splenectomy treatment failure were ≥3 lines of pharmacologic treatment, whereas isolated thrombocytopenia, primary ITP, and age ≤40 years had a strong association with response. The multivariable regression confirmed that treatment failure with multiple lines of medical therapy was associated with the failure to respond to splenectomy.
conclusionOverall, the study demonstrates that splenectomy is an effective treatment option for immune-mediated cytopenias with a low complication rate.
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