Long-term Outcome of Splenectomy in Immune Thrombocytopenia (ITP)

ITP is a chronic illness with frequent mucosal bleeding. Though the first line treatment is corticosteroids, relapse is frequent which necessitates splenectomy. Response to splenectomy is usually good initially; however, over the years relapses are frequent. Drugs then used are azathioprine, mycophenolate mofetil, anti-D globulin, TPO-receptor agonists, rituximab, cyclosporine, etc. Ultimately there is a small subset of patients who may require a small dose of prednisolone lifelong.