Splenectomy in Lymphoproliferative Disorders: A Single Eastern European Center Experience
Abstract
:1. Introduction
2. Materials and Methods
3. Results
- Response to first-line treatment (mostly chemotherapy-61.5%) was generally partial (57.7% cases). As expected, chemotherapy as a single treatment was not associated with complete response in these patients. Thus, 76.9% (20/26) needed second line therapy, which was splenectomy in 80% of cases. The benefit of this therapeutic option was very good, because there was a 60% complete response (CR) rate.
- Splenectomy represented the first line treatment for only 34.6% of cases.
- 38.5% of patients presented different side effects after splenectomy (n = 26). Most of these were thrombotic complications in the abdominal area (four cases), followed by infections (approximately 30%), mechanical complications (eventration, hernia), and very rarely bleeding (accounting for 10% of all complications after splenectomy, respectively 3.8% of splenectomized patients).
4. Discussion
- The number of enrolled patients was low;
- We selected a control group of patients with NHL (non-splenectomized) to match the splenectomized ones as close as possible, before splenectomy took place. There might be a selection bias, as the discussed pathology is rare, and the study comprises only one center, which is located in a large emergency hospital in the capital city, receiving all types of hematological disorders; furthermore, splenectomy is not a frequently used procedure in malignant hematology.
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Parameter | Lot | Value | p |
---|---|---|---|
Age (years) | SMZL Indolent NHL | 59.5 ± 9.7 61.5 ± 10.4 | NS |
Splenectomized Non-splenectomized | 59.0 ± 9.5 55.1 ± 17.6 | NS | |
Hemoglobin (g/dL) | SMZL Indolent NHL | 9.5 ± 2.1 11.2 ± 1.9 | 0.049 |
Splenectomized Non-splenectomized | 10.3 ± 2.2 10.5 ± 2.6 | NS | |
Leucocytes (× 103/mmc) | SMZL Indolent NHL | 18.3 ± 16.8 9.3 ± 4.2 | NS |
Splenectomized Non-splenectomized | 16.9 ± 15.5 8.6+ ± 4.1 | 0.050 | |
Thrombocytes (× 103/mmc) | SMZL Indolent NHL | 172.2 ± −97.0 270.7 ± 133.0 | 0.019 |
Risk rates (OR) | |||
Lymphocytosis | SMZL Indolent NHL | 6.00 | 0.018 |
Splenectomized Non-splenectomized | 9.15 | 0.0004 | |
Low albumin | SMZL Indolent NHL | 1.73 | NS |
Splenectomized Non-splenectomized | 3.15 | 0.040 | |
Autoimmune anemia | SMZL Indolent NHL | 3.78 | NS |
Splenectomized Non-splenectomized | 6.84 | 0.027 | |
Advanced vs. early stage (Ann-Arbor) | SMZL Indolent NHL | NS | NS |
Splenectomized Non-splenectomized | 2.58 | NS |
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Onisâi, M.; Vlădăreanu, A.-M.; Nica, A.; Spînu, A.; Găman, M.; Bumbea, H.; Voican, I.; Iordan, I.; Alexandru, A.; Zdrenghea, M.; et al. Splenectomy in Lymphoproliferative Disorders: A Single Eastern European Center Experience. Medicina 2020, 56, 12. https://doi.org/10.3390/medicina56010012
Onisâi M, Vlădăreanu A-M, Nica A, Spînu A, Găman M, Bumbea H, Voican I, Iordan I, Alexandru A, Zdrenghea M, et al. Splenectomy in Lymphoproliferative Disorders: A Single Eastern European Center Experience. Medicina. 2020; 56(1):12. https://doi.org/10.3390/medicina56010012
Chicago/Turabian StyleOnisâi, Minodora, Ana-Maria Vlădăreanu, Adriana Nica, Andreea Spînu, Mihaela Găman, Horia Bumbea, Irina Voican, Iuliana Iordan, Adrian Alexandru, Mihnea Zdrenghea, and et al. 2020. "Splenectomy in Lymphoproliferative Disorders: A Single Eastern European Center Experience" Medicina 56, no. 1: 12. https://doi.org/10.3390/medicina56010012