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

Amini, S.N.; Nelson, V.S.; Sobels, A.; Schoones, J.W.; Zwaginga, J.J.; Schipperus, M.R. (2020)

Article / Letter to editor

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.

• ITP
• Scintigraphy
• Indium labelling
• Autologous platelet sequestration
• Liver
• Spleen
• Systematic review
• Meta-analysis

• All authors: Amini, S.N.; Nelson, V.S.; Sobels, A.; Schoones, J.W.; Zwaginga, J.J.; Schipperus, M.R.
• Date: 2020-09-01
• Journal: Critical Reviews in Oncology/Hematology
• Volume: 153
• DOI: doi:10.1016/j.critrevonc.2020.103040