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. 2014 Jan;55(1):121-7.
doi: 10.3109/10428194.2013.794269. Epub 2013 May 15.

Splenectomy in patients with myeloproliferative neoplasms: efficacy, complications and impact on survival and transformation

Fabio P S Santos  1 , Constantine S Tam, Hagop Kantarjian, Jorge Cortes, Deborah Thomas, Raphael Pollock, Srdan Verstovsek
Affiliations

Splenectomy in patients with myeloproliferative neoplasms: efficacy, complications and impact on survival and transformation

Fabio P S Santos et al. Leuk Lymphoma. 2014 Jan.

Abstract

Splenectomy may be an effective therapeutic option for treating massive splenomegaly in patients with myeloproliferative neoplasms (MPNs). There are still limited data on its short- and long-term benefits and risks. Efficacy and short-term complications were analyzed in 94 patients with different MPNs who underwent splenectomy at M. D. Anderson Cancer Center. The long-term impact of splenectomy on overall survival (OS) and transformation free survival (TFS) was evaluated in 461 patients with myelofibrosis (MF) seen at M. D. Anderson, including 50 who underwent splenectomy during disease evolution. Splenectomy improved anemia and thrombocytopenia in 47% and 66% of patients, respectively. The most common complications were leukocytosis (76%), thrombocytosis (43%) and venous thromboembolism (16%). Post-operative mortality was 5%. Among patients with MF, splenectomy during disease evolution was associated with decreased OS (hazard ratio [HR] = 2.17, p < 0.0001) and TFS (HR = 2.17, p < 0.0001). This effect was independent of the Dynamic International Prognostic Scoring System. Splenectomy is a possible therapeutic option for patients with MF and other MPNs, and its greatest benefits are related to improvement in spleen pain and discomfort, anemia and thrombocytopenia. However, in patients with MF it appears to be associated with increased mortality.

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Conflict of interest statement

Conflict of Interest Disclosure: No conflicts of interest exist for any author

Figures

Figure 1
Figure 1
(A) OS post-splenectomy of MPN patients who underwent splenectomy at MDACC. (B) OS post-splenectomy by time period of surgery. OS, overall survival.
Figure 1
Figure 1
(A) OS post-splenectomy of MPN patients who underwent splenectomy at MDACC. (B) OS post-splenectomy by time period of surgery. OS, overall survival.
Figure 2
Figure 2
(A) OS of 50 MF patients who underwent splenectomy during disease evolution compared to 411 control MF patients; (B) TFS by splenectomy status; (C) Freedom from blast transformation by presence of splenectomy during disease evolution. CI, confidence interval; HR, Hazard Ratio; OS, Overall Survival; TFS, transformation-free survival.
Figure 2
Figure 2
(A) OS of 50 MF patients who underwent splenectomy during disease evolution compared to 411 control MF patients; (B) TFS by splenectomy status; (C) Freedom from blast transformation by presence of splenectomy during disease evolution. CI, confidence interval; HR, Hazard Ratio; OS, Overall Survival; TFS, transformation-free survival.
Figure 2
Figure 2
(A) OS of 50 MF patients who underwent splenectomy during disease evolution compared to 411 control MF patients; (B) TFS by splenectomy status; (C) Freedom from blast transformation by presence of splenectomy during disease evolution. CI, confidence interval; HR, Hazard Ratio; OS, Overall Survival; TFS, transformation-free survival.
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References

    1. Visani G, Finelli C, Castelli U, et al. Myelofibrosis with myeloid metaplasia: clinical and haematological parameters predicting survival in a series of 133 patients. Br J Haematol. 1990;75:4–9. - PubMed
    1. Cervantes F, Dupriez B, Pereira A, et al. New prognostic scoring system for primary myelofibrosis based on a study of the International Working Group for Myelofibrosis Research and Treatment. Blood. 2009;113:2895–2901. - PubMed
    1. Mesa RA, Schwager S, Radia D, et al. The Myelofibrosis Symptom Assessment Form (MFSAF): an evidence-based brief inventory to measure quality of life and symptomatic response to treatment in myelofibrosis. Leuk Res. 2009;33:1199–1203. - PMC - PubMed
    1. Abu-Hilal M, Tawaker J. Portal hypertension secondary to myelofibrosis with myeloid metaplasia: a study of 13 cases. World J Gastroenterol. 2009;15:3128–3133. - PMC - PubMed
    1. Mesa RA, Elliott MA, Tefferi A. Splenectomy in chronic myeloid leukemia and myelofibrosis with myeloid metaplasia. Blood Rev. 2000;14:121–129. - PubMed

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