Outcomes of splenectomy in relapsed/refractory autoimmune hemolytic anemia
10.3760/cma.j.issn.0253-2727.2019.02.007
- VernacularTitle: 复发/难治自身免疫性溶血性贫血患者脾切除术疗效分析
- Author:
Sibin FAN
1
;
Zhijun WANG
;
Qiang MAO
;
Chunfan TONG
;
Weitao ZHAI
;
Yizhou ZHENG
;
Chaoxia SUN
;
Jun SHI
Author Information
1. Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
- Publication Type:Journal Article
- Keywords:
Autoimmune hemolytic anemia;
Relapsed;
Refractory;
Splenectomy;
Outcome
- From:
Chinese Journal of Hematology
2019;40(2):132-136
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the outcomes of splenectomy in the treatment of relapsed/refractory autoimmune hemolytic anemia (AIHA).
Methods:Retrospective analysis was performed in 30 cases with relapsed/refractory AIHA who were treated with splenectomy in our hospital. The pre- and post-operative blood routine indexes and responses were followed up.
Results:Among the 30 relapsed/refractory AIHA patients, 20 were pure AIHA (including 13 patients with warm antibody AIHA, 2 with warm-cold double antibody AIHA and 5 with Coombs negative AIHA) and 10 were Evans syndrome. The short-term response was evaluated 10-14 days after operation, and the overall response rate (ORR) of short-term response was 90% [12 cases in complete response (CR), 6 cases in partial response (PR)] in 20 therapeutic evaluable cases. Among 13 patients with long-term follow-up data, except 3 patients with Evans syndrome died (2 cases were refractory to splenectomy, 1 case relapsed after surgery), the ORR of 10 patients with relapsed/refractory pure AIHA at 6 months and 12 months were 90% (9/10) and 70% (7/10), respectively, with a median follow-up of 14 (4-156) months. At the end of follow-up, 3 cases had maintained CR for more than 3 years.
Conclusion:The short-term response of splenectomy as a second-line treatment for relapsed/refractory AIHA is satisfactory, and long-term outcome of splenectomy is up to 70% at 1 year. Approximately one-third of patients could maintain sustained remission.
