Splenectomy in children with idiopathic thrombocytopenic purpura: A prospective study of 134 children from the Intercontinental Childhood ITP Study Group

Pediatric Blood and Cancer - Tập 49 Số 6 - Trang 829-834 - 2007
Thomas Kühne1, Victor S. Blanchette2, George R. Buchanan3, Ugo Ramenghi4, Hugo Donato5, R. Y. J. Tamminga6, Johannes Rischewski1, Willi Berchtold7, Paul Imbach1
1University of Basel
2University of Toronto
3The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
4University of Turin
5Children's Hospital, San Justo, Buenos Aires, Argentina
6University of Groningen
7University of Applied Sciences of Aargau

Tóm tắt

AbstractBackgroundSplenectomy is an effective procedure for children and adults with severe or refractory idiopathic thrombocytopenic purpura (ITP). Data regarding pediatric patients are limited.ProcedureSixty‐eight Intercontinental Childhood ITP Study Group (ICIS) investigators from 57 institutions in 25 countries participated in a splenectomy registry. Data from 153 patients were submitted, of whom 134 had a splenectomy and were analyzed.ResultsThe median age at splenectomy was 11.8 (2.7–20.7) years. The median postsplenectomy follow‐up was 2.0 (0.1–4.5) years. Pre‐splenectomy vaccination was not administered in 21 children (15.7%). Open and laparoscopic splenectomy procedures were performed in 67 and 65 evaluable children, respectively. Surgical technique was not reported in two children. Overall immediate platelet response to splenectomy was achieved in 113 patients (86.3%). Eighty percent of responders maintained their status of response during the following 4 years. Older age, longer duration of ITP, and male gender correlated with a complete response. Post‐splenectomy sepsis was reported in seven patients without lethal outcome, although sepsis might be differently defined at participating institutions.ConclusionsSplenectomy is effective in children with ITP. Management varies greatly in different institutions. These Registry data may serve as a basis for future clinical trials to assess the indication and timing of splenectomy. Pediatr Blood Cancer 2007;49:829–834. © 2006 Wiley‐Liss, Inc.

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Pediatric Blood and Cancer

Tập 49 Số 6

829-834

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