Splenectomy may be considered in diseases where sequestration is believed to be a significant contributor to one or more cytopenias. Criteria to evaluate the change in hematologic parameters can help determine how effective the procedure was.
|
Parameter |
Finding |
Response |
|
red blood cells |
decrease in hemoglobin |
poor |
|
|
hemoglobin unchanged or increase < 1 g/dL |
none |
|
|
hemoglobin increase >= 1 but < 3 g/dL |
fair |
|
|
hemoglobin increase > 3 g/dL and hemoglobin < 12 g/dL |
good |
|
|
hemoglobin increase > 3 g/dL and hemoglobin < 12 g/dL |
excellent |
|
platelets |
decrease in platelet count |
poor |
|
|
platelet count unchanged or increase < 20,000 per µL |
none |
|
|
increase platelet count >= 20,000 but < 50,000 per µL |
fair |
|
|
increase platelet count >= 50,000 with platelet count < 150,000 per µL |
good |
|
|
increase platelet count >= 50,000 with platelet count >= 150,000 per µL |
excellent |
|
neutrophils |
decrease in neutrophil count |
poor |
|
|
neutrophil count unchanged or increase < 500 per µL |
none |
|
|
increase in neutrophil count > 500 but < 1,000 per µL |
fair |
|
|
increase in neutrophil count >= 1,000 with absolute neutrophil count < 2,000 per µL |
good |
|
|
increase in neutrophil count >= 1,000 with absolute neutrophil count >= 2,000 per µL |
excellent |
where:
• In Table 2 (page 54, Seymour) a decrease in any of the cell counts was considered as a "none" response. I changed it to "poor".
• The data in Table 2 (page 54, Seymour) is expressed in 10^9/L.
Limitations:
• Evaluation for effectiveness should be done after the body has stabilized from the blood loss and other changes induced by surgery.
Specialty: Hematology Oncology, Clinical Laboratory, Surgery, general
ICD-10: ,
