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Splenectomy for immune thrombocytopenia : our 11-year experience

Splenectomy has been practiced for the treatment of ITP for the past few decades. Currently it is utilised when a patient is either dependent or resistant to steroid treatment and the platelet count remains less than 30×109/L. Recently new agents have been added to the armamentarium used to treat I...

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Main Author: Antel, Katherine
Other Authors: Novitzky, Nicolas
Format: Thesis
Language:English
Published: Department of Medicine 2015
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access_status_str Open Access
author Antel, Katherine
author2 Novitzky, Nicolas
author_browse Antel, Katherine
Novitzky, Nicolas
author_facet Novitzky, Nicolas
Antel, Katherine
author_sort Antel, Katherine
collection Thesis
description Splenectomy has been practiced for the treatment of ITP for the past few decades. Currently it is utilised when a patient is either dependent or resistant to steroid treatment and the platelet count remains less than 30×109/L. Recently new agents have been added to the armamentarium used to treat ITP, including immune-suppressants such as rituximab and the new thrombopoetin-receptor agonists. This has brought into question the role of surgery for the treatment of ITP, and the need to compare the response and complication rates of splenectomy to these newer agents. Historic studies done on splenectomy for the treatment of ITP have been performed in the setting of low HIV prevalence. There is a relative paucity of data on the response rate in HIV-associated thrombocytopenia to splenectomy and the durability of response to splenectomy is unclear in this patient population. We retrospectively analysed 73 consecutive patients who underwent splenectomy for ITP from 2001 to 2011. The primary objective was to determine the rate of complete response, this was defined as a platelet count greater than 100×109/L at one year post splenectomy. Results were compared between HIV positive and HIV negative patients. The secondary objectives were: to evaluate the intra-operative and post†operative complications and mortality in the HIV positive and HIV negative groups, and to investigate for associations between co-morbidities, pre-operative treatment and response to splenectomy.
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institution University of Cape Town (South Africa)
language eng
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2015
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spelling oai:open.uct.ac.za:11427/14134 Splenectomy for immune thrombocytopenia : our 11-year experience Antel, Katherine Novitzky, Nicolas Haematology Splenectomy has been practiced for the treatment of ITP for the past few decades. Currently it is utilised when a patient is either dependent or resistant to steroid treatment and the platelet count remains less than 30×109/L. Recently new agents have been added to the armamentarium used to treat ITP, including immune-suppressants such as rituximab and the new thrombopoetin-receptor agonists. This has brought into question the role of surgery for the treatment of ITP, and the need to compare the response and complication rates of splenectomy to these newer agents. Historic studies done on splenectomy for the treatment of ITP have been performed in the setting of low HIV prevalence. There is a relative paucity of data on the response rate in HIV-associated thrombocytopenia to splenectomy and the durability of response to splenectomy is unclear in this patient population. We retrospectively analysed 73 consecutive patients who underwent splenectomy for ITP from 2001 to 2011. The primary objective was to determine the rate of complete response, this was defined as a platelet count greater than 100×109/L at one year post splenectomy. Results were compared between HIV positive and HIV negative patients. The secondary objectives were: to evaluate the intra-operative and post†operative complications and mortality in the HIV positive and HIV negative groups, and to investigate for associations between co-morbidities, pre-operative treatment and response to splenectomy. 2015-09-30T13:43:59Z 2015-09-30T13:43:59Z 2015 Master Thesis Masters MSc http://hdl.handle.net/11427/14134 eng application/pdf Department of Medicine Faculty of Health Sciences University of Cape Town
spellingShingle Haematology
Antel, Katherine
Splenectomy for immune thrombocytopenia : our 11-year experience
thesis_degree_str Master's
title Splenectomy for immune thrombocytopenia : our 11-year experience
title_full Splenectomy for immune thrombocytopenia : our 11-year experience
title_fullStr Splenectomy for immune thrombocytopenia : our 11-year experience
title_full_unstemmed Splenectomy for immune thrombocytopenia : our 11-year experience
title_short Splenectomy for immune thrombocytopenia : our 11-year experience
title_sort splenectomy for immune thrombocytopenia our 11 year experience
topic Haematology
url http://hdl.handle.net/11427/14134
work_keys_str_mv AT antelkatherine splenectomyforimmunethrombocytopeniaour11yearexperience