Splenectomy in children with idiopathic thrombocytopenic purpura: A prospective study of 134 children from the intercontinental childhood ITP study group

Thomas Kühne, Victor Blanchette, George R. Buchanan, Ugo Ramenghi, Hugo Donato, Rienk Y J Tamminga, Johannes Rischewski, Willi Berchtold, Paul Imbach

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Background. Splenectomy is an effective procedure for children and adults with severe or refractory idiopathic thrombocytopenic purpura (ITP). Data regarding pediatric patients are limited. Procedure. Sixty-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. Results. The 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. Conclusions. Splenectomy 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.

Original languageEnglish (US)
Pages (from-to)829-834
Number of pages6
JournalPediatric Blood and Cancer
Volume49
Issue number6
DOIs
StatePublished - Nov 2007

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Idiopathic Thrombocytopenic Purpura
Splenectomy
Prospective Studies
Registries
Sepsis
Vaccination
Blood Platelets
Research Personnel
Clinical Trials
Pediatrics

Keywords

  • Blood platelets
  • ITP
  • Pediatrics
  • Registry
  • Splenectomy
  • Thrombocytopenia

ASJC Scopus subject areas

  • Cancer Research
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Splenectomy in children with idiopathic thrombocytopenic purpura : A prospective study of 134 children from the intercontinental childhood ITP study group. / Kühne, Thomas; Blanchette, Victor; Buchanan, George R.; Ramenghi, Ugo; Donato, Hugo; Tamminga, Rienk Y J; Rischewski, Johannes; Berchtold, Willi; Imbach, Paul.

In: Pediatric Blood and Cancer, Vol. 49, No. 6, 11.2007, p. 829-834.

Research output: Contribution to journalArticle

Kühne, Thomas ; Blanchette, Victor ; Buchanan, George R. ; Ramenghi, Ugo ; Donato, Hugo ; Tamminga, Rienk Y J ; Rischewski, Johannes ; Berchtold, Willi ; Imbach, Paul. / Splenectomy in children with idiopathic thrombocytopenic purpura : A prospective study of 134 children from the intercontinental childhood ITP study group. In: Pediatric Blood and Cancer. 2007 ; Vol. 49, No. 6. pp. 829-834.
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abstract = "Background. Splenectomy is an effective procedure for children and adults with severe or refractory idiopathic thrombocytopenic purpura (ITP). Data regarding pediatric patients are limited. Procedure. Sixty-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. Results. The 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. Conclusions. Splenectomy 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.",
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AB - Background. Splenectomy is an effective procedure for children and adults with severe or refractory idiopathic thrombocytopenic purpura (ITP). Data regarding pediatric patients are limited. Procedure. Sixty-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. Results. The 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. Conclusions. Splenectomy 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.

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