Splenectomy in patients with thalassemia major: Evaluation of 35 cases

Abstract

Objective: Beta-thalassemia is common, worldwide, autosomal recessive and inherited type of anemia which results from absent or reduced synthesis of beta globin. Splenectomy may be performed for the treatment of many hematologic diseases. The aim of this study is to discuss recorded data of thalassemia major patients who underwent splenectomy.

Methods: The records of 782 patients with thalassemia major were reviewed retrospectively. Of these patients, 35 splenectomized patients with available data were included in the study. Recorded data of patients were evaluated as for age at diagnosis, gender, age at splenectomy, surgical indications, chelation therapy, annual transfusion requirements, and postoperative clinical response. Statistical analyses were performed with statistical package of SPSS version 13.0.

Results: Twenty-two (63%) male and 13 (37%) female patients were included in the study. Mean age at diagnosis was 8 +/- 2 months and splenectomy was 8.5 years. The main indication for splenectomy was increased transfusion requirement (57.14%). The annual transfusion requirement reduced from preoperative 235 +/- 30 mL/kg to 115 +/- 15 mL/kg postoperatively. Mean serum ferritin levels were 1745 +/- 761 ng/mL, and 1985 +/- 570 ng/mL before, and after splenectomy. None of the patients developed any complications such as sepsis or coagulation disorder.

Conclusion: These results suggest that splenectomy is beneficial to improve the quality of the lives of patients and significantly reducing blood consumption. Inadequate iron chelation therapy may be associated with progression to splenectomy.