Splenectomy for thrombocytopenia associated with systemic lupus erythematosus in 11 Chinese patients

Abstract

Since the role of splenectomy in treating thrombocytopenia associated with systemic lupus erythematosus has been controversial, the study was focused on determining the efficacy of splenectomy in the SLE-associated thrombocytopenia. Between 1980 and 2008, 11 patients with SLE underwent splenectomy for treating their thrombocytopenia. Surgical indications, operative mortality and morbidity, and haematological outcomes were followed in both short term (first 30 days) and long term (last recorded platelet count, last contact, or death). Indications for splenectomy included: thrombocytopenia refractory to (63.7%), dependent on (27.3%), or patient intolerance of (9%) medical treatments. Perioperative mortality and morbidity was 0%. The overall rate of early partial or complete response rate to splenectomy was 100%. After a median follow-up of 36 months, 9 (81.9%) patients had sustained complete or partial response without relapse. Eight (72.8%) of these patients required adjunctive medical therapy, whereas the other 1 (9%) did not. The remaining 2 (18.2%) patients relapsed, could not been subsequently salvaged to at least partial response with further treatments. The overall PR or CR to splenectomy combined with medical therapy was 81.8%. Splenectomy should be considered as a safe and efficacious therapy for the severe thrombocytopenia associated with SLE in some selected patients.