Indications and outcomes for elective splenectomy in myelofibrosis: Mayo Clinic experience29
| Variable . | Result . |
|---|---|
| Preoperative | |
| Surgical indications | |
| Anemia | 78 (25%) |
| Symptomatic splenomegaly | 156 (49%) |
| Portal hypertension | 47 (15%) |
| Severe thrombocytopenia | 33 (11%) |
| Median intervals, mo (range) | |
| Diagnosis to splenectomy (n = 314) | 26.3 (0-389) |
| Follow-up period from diagnosis (n = 314) | 54.6 (0.6-487) |
| Follow-up period from splenectomy (n = 314) | 18.6 (0.2-151) |
| Perioperative | |
| Median spleen mass, g (range) | 2700 (380-11 750) |
| Complications, no. (%) | 87 (27.7) |
| Bleeding | 44 (14.0) |
| Thrombosis | 31 (9.9) |
| Infection | 31 (9.9) |
| Fatal complications, no. (%) | 21 (6.7) |
| Infection | 8 (2.6) |
| Hemorrhage | 7 (2.2) |
| Thrombosis | 2 (0.6) |
| Other | 5 (1.6) |
| Median hospital stay, d (range) | 9 (1-63) |
| Laboratory values at discharge, median (range) | |
| Hemoglobin, g/dL | 10 (7-16.3) |
| White blood cell count, ×109/L | 21.2 (1.2-217) |
| Platelet count, ×109/L | 256 (10-1968) |
| Patients (n, %) with > 450 × 109/L | 90 (28.7%) |
| Patients (n, %) with > 1000 × 109/L | 17 (5.4%) |
| Postsplenectomy outcomes | |
| Leukemic transformation | 45 (14.3%) |
| Accelerated hepatomegaly | 32 (10.2%) |
| Long-term improvements | |
| Symptomatic splenomegaly | 121/156 (48.8%) |
| Anemia | 39/78 (50.0%) |
| Portal hypertension | 19/47 (40.4%) |
| Severe thrombocytopenia | 10/33 (30.3%) |
| Survival after splenectomy (by indication) | |
| Overall | 19 mo (95% CI, 14-22) |
| Anemia | 70.1% (at 1 y) |
| Symptomatic splenomegaly | 66% (at 1 y) |
| Portal hypertension | 59.5% (at 1 y) |
| Severe thrombocytopenia | 66.7% (at 1 y) |
| Variable . | Result . |
|---|---|
| Preoperative | |
| Surgical indications | |
| Anemia | 78 (25%) |
| Symptomatic splenomegaly | 156 (49%) |
| Portal hypertension | 47 (15%) |
| Severe thrombocytopenia | 33 (11%) |
| Median intervals, mo (range) | |
| Diagnosis to splenectomy (n = 314) | 26.3 (0-389) |
| Follow-up period from diagnosis (n = 314) | 54.6 (0.6-487) |
| Follow-up period from splenectomy (n = 314) | 18.6 (0.2-151) |
| Perioperative | |
| Median spleen mass, g (range) | 2700 (380-11 750) |
| Complications, no. (%) | 87 (27.7) |
| Bleeding | 44 (14.0) |
| Thrombosis | 31 (9.9) |
| Infection | 31 (9.9) |
| Fatal complications, no. (%) | 21 (6.7) |
| Infection | 8 (2.6) |
| Hemorrhage | 7 (2.2) |
| Thrombosis | 2 (0.6) |
| Other | 5 (1.6) |
| Median hospital stay, d (range) | 9 (1-63) |
| Laboratory values at discharge, median (range) | |
| Hemoglobin, g/dL | 10 (7-16.3) |
| White blood cell count, ×109/L | 21.2 (1.2-217) |
| Platelet count, ×109/L | 256 (10-1968) |
| Patients (n, %) with > 450 × 109/L | 90 (28.7%) |
| Patients (n, %) with > 1000 × 109/L | 17 (5.4%) |
| Postsplenectomy outcomes | |
| Leukemic transformation | 45 (14.3%) |
| Accelerated hepatomegaly | 32 (10.2%) |
| Long-term improvements | |
| Symptomatic splenomegaly | 121/156 (48.8%) |
| Anemia | 39/78 (50.0%) |
| Portal hypertension | 19/47 (40.4%) |
| Severe thrombocytopenia | 10/33 (30.3%) |
| Survival after splenectomy (by indication) | |
| Overall | 19 mo (95% CI, 14-22) |
| Anemia | 70.1% (at 1 y) |
| Symptomatic splenomegaly | 66% (at 1 y) |
| Portal hypertension | 59.5% (at 1 y) |
| Severe thrombocytopenia | 66.7% (at 1 y) |
CI indicates confidence interval.