TY - JOUR
T1 - Splenectomy and thrombosis
T2 - The case of thalassemia intermedia
AU - Taher, A. T.
AU - Musallam, K. M.
AU - Karimi, M.
AU - El-Beshlawy, A.
AU - Belhoul, K.
AU - Daar, S.
AU - Saned, M.
AU - Cesaretti, C.
AU - Cappellini, M. D.
PY - 2010/10
Y1 - 2010/10
N2 - Background: Hypercoagulability in splenectomized patients with thalassemia intermedia (TI) has been extensively evaluated. However, clinical and laboratory characteristics of patients who eventually develop overt thromboembolic events (TEE) are poorly studied. Patients/Methods: Three Groups of TI patients (n = 73 each) were retrospectively identified from a registry involving six centers across the Middle East and Italy: Group I, all splenectomized patients with a documented TEE; Group II, age- and sex-matched splenectomized patients without TEE; and Group III, age- and sex-matched nonsplenectomized patients without TEE. Retrieved data included demographics, laboratory parameters, clinical complications, and received treatments that may influence TEE development, and reflected the period prior to TEE occurrence in Group I. Results: The mean age of Group I patients at development of TEE was 33.1 ± 11.7 years, with a male to female ratio of 33:40. TEE were predominantly venous (95%) while four patients (5%) had documented stroke. Among studied parameters, Group I patients weremore likely to have a nucleated red blood cell (NRBC) count ≥ 300 × 106 L-1, a platelet count ≥ 500 × 109 L-1 and evidence of pulmonary hypertension (PHT), or be transfusion nai{dotless}̈ve. The median time to thrombosis following splenectomy was 8 years. Patients with an NRBC count ≥ 300 × 106 L-1, a platelet count ≥ 500 × 109 L-1, or who were transfusion naive also had a shorter time to thrombosis following splenectomy. Conclusion: Splenectomized TI patients who will develop TEE may be identified early on by high NRBC and platelet counts, evidence of PHT, and transfusion naivety.
AB - Background: Hypercoagulability in splenectomized patients with thalassemia intermedia (TI) has been extensively evaluated. However, clinical and laboratory characteristics of patients who eventually develop overt thromboembolic events (TEE) are poorly studied. Patients/Methods: Three Groups of TI patients (n = 73 each) were retrospectively identified from a registry involving six centers across the Middle East and Italy: Group I, all splenectomized patients with a documented TEE; Group II, age- and sex-matched splenectomized patients without TEE; and Group III, age- and sex-matched nonsplenectomized patients without TEE. Retrieved data included demographics, laboratory parameters, clinical complications, and received treatments that may influence TEE development, and reflected the period prior to TEE occurrence in Group I. Results: The mean age of Group I patients at development of TEE was 33.1 ± 11.7 years, with a male to female ratio of 33:40. TEE were predominantly venous (95%) while four patients (5%) had documented stroke. Among studied parameters, Group I patients weremore likely to have a nucleated red blood cell (NRBC) count ≥ 300 × 106 L-1, a platelet count ≥ 500 × 109 L-1 and evidence of pulmonary hypertension (PHT), or be transfusion nai{dotless}̈ve. The median time to thrombosis following splenectomy was 8 years. Patients with an NRBC count ≥ 300 × 106 L-1, a platelet count ≥ 500 × 109 L-1, or who were transfusion naive also had a shorter time to thrombosis following splenectomy. Conclusion: Splenectomized TI patients who will develop TEE may be identified early on by high NRBC and platelet counts, evidence of PHT, and transfusion naivety.
KW - Hypercoagulability
KW - Splenectomy
KW - Thalassemia intermedia
KW - Thromboembolism
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U2 - 10.1111/j.1538-7836.2010.03940.x
DO - 10.1111/j.1538-7836.2010.03940.x
M3 - Article
C2 - 20546125
AN - SCOPUS:78649339507
SN - 1538-7933
VL - 8
SP - 2152
EP - 2158
JO - Journal of Thrombosis and Haemostasis
JF - Journal of Thrombosis and Haemostasis
IS - 10
ER -