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Health-related quality of life profile of patients with immune thrombocytopenia in the real life is impaired by splenectomy

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Abstract

The impact of splenectomy on health-related quality of life (HRQoL) in patients with immune thrombocytopenia (ITP) remains scarcely explored. Therefore, we evaluated HRQoL with the 36-Item Short-Form Health Survey (SF-36) in an internal cohort of 69 chronic ITP patients, overall and by type of treatment. Of these patients, 26 patients were splenectomized, while other patients were treated medically with thrombopoietin-receptor agonists (TPO-RAs) or immunosuppressive treatment. We also compared HRQoL of the splenectomized patients (internal cohort) with an external cohort of 63 splenectomized ITP patients and the general population. The median follow-up was 10 years (range 1–20). Splenectomized patients had a worse overall HRQoL profile than those who received medical therapy either with TPO-RAs or other treatments (OT), with clinically meaningful differences registered in several domains. These included physical functioning (Δ = − 17.0 and Δ = − 15.2, for TPO-Ras and OT, respectively, p = 0.065), role physical (Δ = − 9.7 and Δ = − 13.8, p = 0.483), and bodily pain (Δ = − 14.2 and Δ = − 18.8, p = 0.053). Compared to the general population, both internal and external splenectomized cohorts had an impaired HRQoL profile. Further studies on HRQoL in splenectomized ITP patients are needed to better understand the long-term impact of this surgical procedure.

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Data and medical charts are available at the “S.C. Ematologia e CTMO, Ospedale Businco, Via Jenner sn, 09124, Cagliari (Italy)

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Acknowledgements

We are deeply grateful to the patients who participated in this study.

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Author notes

  1. Giovanni Caocci and Fabio Efficace contributed equally to this work.

Authors and Affiliations

  1. SC Ematologia e CTMO, Ospedale Businco, ARNAS Brotzu Cagliari, Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari, Via Jenner, sn 09124, Cagliari, Italy

    Giovanni Caocci, Olga Mulas, Alessia Maxia, Alessandro Costa, Maria Pina Simula, Emilio Usala & Giorgio La Nasa

  2. Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy

    Fabio Efficace & Francesco Cottone

Authors
  1. Giovanni Caocci
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  2. Fabio Efficace
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  3. Olga Mulas
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  4. Francesco Cottone
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  5. Alessia Maxia
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  6. Alessandro Costa
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  7. Maria Pina Simula
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  8. Emilio Usala
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  9. Giorgio La Nasa
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Contributions

Conception and design: GC, FE

Collection and assembly of data: GC, FE, OM, FC, AM, AC, MPS, EU, GLN

Statistical analysis: FC, FE

Manuscript writing: GC, FC, FE

Final approval of the manuscript: GC, FE, OM, FC, AM, AC, MPS, EU, GLN

Corresponding author

Correspondence to Giovanni Caocci.

Ethics declarations

Ethics approval and consent to participate

Data on patients were retrospectively collected in accordance with the 1975 guidelines of the Declaration of Helsinki. The research was approved by the Ethical Committee of Cagliari (N.PG/2021/14270)

Conflict of interest

FE: consultancy for Abbvie, Amgen, Janssen, Takeda, and grants from Amgen and Abbvie (to his Institution), outside the submitted work. The other authors declare no competing interests.

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Caocci, G., Efficace, F., Mulas, O. et al. Health-related quality of life profile of patients with immune thrombocytopenia in the real life is impaired by splenectomy. Ann Hematol 101, 749–754 (2022). https://doi.org/10.1007/s00277-021-04750-2

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  • DOI: https://doi.org/10.1007/s00277-021-04750-2

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