Efficacy and safety of splenectomy in adult chronic XXXX .

@entity1 @entity295 @entity55 @entity134 @entity281 @entity3039
For @entity1 with adult chronic @entity3039 ( @entity3039 ) splenectomy (SE) is a highly effective treatment, but there are still uncertainties regarding the long-term efficacy and safety. We evaluated the long-term efficacy and safety of SE in 48 consecutive adult @entity1 with chronic @entity3039 (26 @entity1 , 22 @entity1 ) who underwent SE between 1990 and 2001 at the General Hospital in Vienna, Austria. All @entity1 had no remission after @entity134 treatment and were @entity134 dependent. The median age at the time of SE was 44 years (range: 16-77 years). Of 48 @entity1 , 37 achieved a complete remission (CR, platelet count >100 x 10(9)/l), 8 a partial remission (PR) (platelet count 30-100 x 10(9)/l), and 2 had no response (NR). The probability of the overall survival was 98% at a median postsplenectomy observation time of 3.5 years. Seven @entity1 with CR and four @entity1 with PR relapsed. There were no relapses after 1 year. The probability of continuous complete remission (CCR) at 10 years was 79%. The probability of having a platelet count of >100 x 10(9)/l or >30 x 10(9)/l was 61% and 67%, respectively, at 5 and 10 years after splenectomy. Of the 11 relapsed @entity1 , 5 had a second CR ( n=3) or PR ( n=2). The postoperative platelet count was the best predictor for a long-term remission. All @entity1 with postoperative platelet counts >250 x 10(9)/l remained in CR. @entity1 aged >45 years had a similar success rate as compared with younger @entity1 . Three @entity1 had @entity281 (one @entity55 and two fever of unknown origin) requiring hospitalization, but none had overwhelming @entity295 .
