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Effects of splenectomy on the general state and prognosis of patients with hematological proliferative disorders
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Abstract
Material and methods: Splenectomy was performed in 50 patients with various hematological proliferative disorders. The main indications were: compression symptoms, hypersplenism and diagnostic excision. The post-splenectomy observation period ranged from 6 to 82 months (mean time 26 months).
Results: An improvement lasting not less than 6 months was achieved in 52% of patients. The best prognosis group included patients with a primary splenic marginal zone lymphoma; 5 long lasting clinical remissions and 3 deaths due to basic disease progression were reported (altogether 15 cases). The worst prognosis group included patients with primary myelofibrosis — no clinical remission was reported and 6 deaths occurred due to disease progression (out of 9 cases). A splenectomy due to hypersplenism resulted in an platelet increase of over 100 × 109/l (89% of patients) and white blood cell increases of over 3 × 109/l (all patients). The post-splenectomy mean increase of the red blood cell count in patients with hypersplenism was not large (0.07 × 1012/l). In two patients however, it reached 0.7 and 1.7 × 1012/ therefore blood transfusion could be avoided. In 22% of patients, serious post splenectomy clinical complications appeared including one death due to a cerebral hemorrhage. In 50% of patients thrombocytemia was observed and in 28% of patients, an asymptomatic thrombosis of the splenic vein occurred.
Conclusions: The best prognosis in patients with proliferative hematological disorders was found in the group with primary splenic marginal zone lymphoma, while respectively the worst prognosis concerned patients with primary myelofibrosis.
Abstract
Material and methods: Splenectomy was performed in 50 patients with various hematological proliferative disorders. The main indications were: compression symptoms, hypersplenism and diagnostic excision. The post-splenectomy observation period ranged from 6 to 82 months (mean time 26 months).
Results: An improvement lasting not less than 6 months was achieved in 52% of patients. The best prognosis group included patients with a primary splenic marginal zone lymphoma; 5 long lasting clinical remissions and 3 deaths due to basic disease progression were reported (altogether 15 cases). The worst prognosis group included patients with primary myelofibrosis — no clinical remission was reported and 6 deaths occurred due to disease progression (out of 9 cases). A splenectomy due to hypersplenism resulted in an platelet increase of over 100 × 109/l (89% of patients) and white blood cell increases of over 3 × 109/l (all patients). The post-splenectomy mean increase of the red blood cell count in patients with hypersplenism was not large (0.07 × 1012/l). In two patients however, it reached 0.7 and 1.7 × 1012/ therefore blood transfusion could be avoided. In 22% of patients, serious post splenectomy clinical complications appeared including one death due to a cerebral hemorrhage. In 50% of patients thrombocytemia was observed and in 28% of patients, an asymptomatic thrombosis of the splenic vein occurred.
Conclusions: The best prognosis in patients with proliferative hematological disorders was found in the group with primary splenic marginal zone lymphoma, while respectively the worst prognosis concerned patients with primary myelofibrosis.
Keywords
splenectomy; hematological proliferative disorders; prognosis
About this articleTitle
Effects of splenectomy on the general state and prognosis of patients with hematological proliferative disorders
Journal
Chirurgia Polska (Polish Surgery)
Issue
Pages
211-219
Published online
2005-01-26
Bibliographic record
Chirurgia Polska 2004;6(4):211-219.
Keywords
splenectomy
hematological proliferative disorders
prognosis
Authors
Ewa Mendek-Czajkowska
Maciej Słomkowski
Sławomir Huszcza
Anna Sikorska
Renata K. Maryniak
Ewa Nita
Agnieszka Łuczak
Stanisław Maj
Alfred Jerzy Meissner
Lech Konopka
