‘Early’ Splenectomy and Survival in Agnogenic Myeloid Metaplasia

J, Benbassat; Penchas, S

doi:10.1159/000207177

Cited by 30 publications

(8 citation statements)

References 3 publications

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“…In the present series a Hb-concentration > 10 g/dl was associated with a favourable prognosis and both in the univariate and the multivariate analysis the Hb-concentration consistently emerged as an important prognostic parameter, being in accordance with previous observations (10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Section: Discussionsupporting

confidence: 92%

“…Several reports on idiopathic myelofibrosis (IMF) have shown that the clinical course and prognosis are extremely variable, with median survival times from diagnosis ranging from 1.4 to 5.2yr (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Results of complex ferrokinetic isotope studies on the site and function of erythropoiesis and measurements of total red cell and plasma volumes have been conflicting with regard to their prognostic significance (19)(20)(21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

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Prognostic factors in idiopathic myelofibrosis: A simple scoring system with prognostic significance

Hasselbalch

Jensen

1990

European J of Haematology

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In a prognostic univariate analysis of a series of 80 patients with idiopathic myelofibrosis the Hb‐concentration, the platelet count and osteomyelosclerosis emerged as factors with prognostic significance. A Hb‐concentration < 10 g/dl was associated with a significantly shorter survival than a Hb‐concentration ≥ 10 g/dl. A platelet count < 100 × 109/1 also implied a significantly shorter survival. Patients with osteomyelosclerosis on X‐ray of the skeleton had a significantly better prognosis as compared to those without osteomyelosclerosis. In a multivariate regression analysis the Hb‐concentration consistently emerged as an important prognostic parameter, whereas the platelet count was only of prognostic significance within the first 6 months from diagnosis and the presence of osteomyelosclerosis emerged as a favourable parameter at 3 and 5 years. Based upon the above parameters and spleen size, a prognostic scoring system was designed which categorized the patients into three prognostic groups with highly different survival times (low risk group = 69 months; intermediate risk group = 33 months; high risk group = 4 months).

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Prognostic factors in idiopathic myelofibrosis: A simple scoring system with prognostic significance

Hasselbalch

Jensen

1990

European J of Haematology

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“…As in 2 patients of the present series, it has been re ported previously that in some IM patients the in crease in hepatic myeloid metaplasia following sple nectomy can be so massive as to provoke prominent clinical and biological signs of liver dysfunction, even leading to death [10,14,15,18,19]. The reason why some patients develop this overwhelming complica tion is not known, and no preoperative clinical or lab oratory data have been found that predict this course [ …”

Section: Discussionmentioning

confidence: 67%

Liver Dysfunction following Splenectomy in Idiopathic Myelofibrosis: A Study of 10 Patients

López‐Guillermo¹,

Cervantes²,

Bruguera

et al. 1991

Acta Haematol

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The hepatic abnormalities that developed after the splenectomy in 10 subjects with idiopathic myelofibrosis were analyzed. In all patients in whom a liver biopsy was performed during the splenectomy, ex-tramedullary hematopoiesis was demonstrated, consisting of dysmorphic megakaryocytes primarily localized in the sinusoids, often accompanied by erythroid precursors. Following splenectomy, a significant increase in both the liver size and serum levels of alkaline phosphatase, bilirubin or γ-glutamyl transpeptidase was found within 6 months, whereas no such increase was observed in the serum aspartate transaminase and alanine transaminase concentrations. In addition, 2 patients developed acute liver failure leading to death at 3 and 4 weeks from splenectomy, respectively. In contrast with these findings, no hepatic alterations were observed in 10 chronic myeloid leukemia patients who were also submitted to splenectomy.

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“…It is still unknown whether splenectomy alters the natural history and prognosis of patients with PMF as no controlled randomized trials have been performed. A retrospective analysis of the effects of splenectomy performed early in the course of the disease showed that the survival of splenectomized patients was similar to, or even shorter than, that of patients treated conservatively (Benbassat & Penchas 1981). Although a policy of early elective splenectomy has its protagonists (Crosby 1972;Mulder et al 1977), it has thus not been widely adopted.…”

Section: Splenectomymentioning

confidence: 99%