Autologous platelet scintigraphy and clinical outcome of splenectomy in immune thrombocytopenia: A systematic review and meta-analysis

S. N. Amini*, V. S. Nelson, A. Sobels, J. W. Schoones, J. J. Zwaginga, M. R. Schipperus

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

Autologous platelet sequestration pattern is associated with post-splenectomy platelet response in patients with immune thrombocytopenia (ITP). However, published results are contradictory, and have not been systematically reviewed. Our aim is to systematically review and meta-analyse the association between sequestration pattern and post-splenectomy platelet response. Articles were selected from MEDLINE when they a) included ITP patients, b) performed scintigraphy, and c) included post-splenectomy platelet response. The 23 included studies (published between 1969-2018) represented 2966 ITP-patients. Response to splenectomy occurred most frequently in patients with a splenic pattern (87.1 % in splenic versus 47.1 % in mixed and 25.5 % in hepatic patterns). A pooled analysis of 8 studies showed an odds ratio of 14.21 (95 % CI: 3.65-55.37) for platelet response in the splenic versus the hepatic group. Our findings indicate that a splenic sequestration pattern is associated with better response after splenectomy. Platelet sequestration patterns may be useful in the clinical decision-making regarding splenectomy.

Original languageEnglish
Article number103040
Number of pages6
JournalCritical Reviews in Oncology/Hematology
Volume153
DOIs
Publication statusPublished - Sep-2020
Externally publishedYes

Keywords

  • ITP
  • Scintigraphy
  • Indium labelling
  • Autologous platelet sequestration
  • Liver
  • Spleen
  • Systematic review
  • Meta-analysis
  • LAPAROSCOPIC SPLENECTOMY
  • ADULT PATIENTS
  • PURPURA
  • PATHOPHYSIOLOGY
  • SEQUESTRATION
  • THERAPY
  • CHOICE
  • SITE

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