SPLENECTOMY FOR AGNOGENIC MYELOID METAPLASIA

  • 1 January 1982
    • journal article
    • research article
    • Vol. 154  (4) , 561-563
Abstract
Only a fraction of the patients with myeloid metaplasia develop indications for splenectomy. Palliation for symptomatic splenomegaly is highly successful. Significant relief from hypersplenism, anemia or thrombocytopenia was achieved in < 1/2 of the patients. Since patients with severe thrombocytopenia are at continuing risk of spontaneous hemorrhage and bleeding after minor trauma, splenectomy appears to be justified in these patients, provided that studies of peripheral blood and bone marrow have excluded those with leukemic conversion. The benefit obtained from splenectomy in patients with chronic anemia requiring frequent transfusions is less certain, particularly in men and patients converting to myeloid metaplasia from polycythemia vera. The continuation of transfusions may result in less morbidity and better palliation than operation. Although the course of this myeloproliferative disorder from 1st symptoms to death frequently extends for more than a decade, the manifestations which may provide an indication for splenectomy usually occur late in the course of the disease. This element as well as the morbidity of the operation makes a thorough evaluation of each patient essential before splenectomy is considered.

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