Our Summary

This research paper explores a treatment option for patients with a disease called myelofibrosis (a type of bone marrow disorder). The treatment involves a stem cell transplant from a donor (alloHSCT), which is the only potential cure for this disease. However, before this treatment can happen, some patients need to have their spleen removed (splenectomy) because their spleen is too large, even after taking a drug called ruxolitinib.

The researchers looked at 12 patients who had their spleens removed before the stem cell transplant between 2016 and 2018. They found that the hospital stay was around 11 days on average, and there were no deaths. There were some complications, though, with half of the patients experiencing some form of problem after surgery.

Despite these complications, the researchers found that the number of white blood cells and platelets (both important for our immune system and blood clotting) increased after the spleen removal. These patients then had their stem cell transplants around 2.6 months after their spleen was removed.

The good news is that all of the transplants were successful, and there were no severe infections or relapses of the disease. Sadly, one patient did die due to a rare condition that affects the small blood vessels. However, seven patients are alive and in complete remission from their disease.

So, the researchers concluded that removing the spleen before a stem cell transplant could be a good option for patients with myelofibrosis who don’t respond well to the drug ruxolitinib.

FAQs

  1. What is the purpose of removing the spleen before a stem cell transplant in patients with myelofibrosis?
  2. What complications may arise from a splenectomy before a stem cell transplant?
  3. What were the results of the stem cell transplants performed after the patients had their spleens removed?

Doctor’s Tip

A helpful tip a doctor might give a patient about splenectomy is to be aware of the potential complications that can occur after surgery, such as infections or bleeding. It’s important to follow post-operative care instructions closely and to notify your doctor immediately if you experience any concerning symptoms. Additionally, be sure to discuss the potential benefits and risks of splenectomy with your healthcare provider before making a decision.

Suitable For

Patients with myelofibrosis who have an enlarged spleen that does not respond well to medication, such as ruxolitinib, may be recommended for splenectomy before undergoing a stem cell transplant. This treatment option can help improve the outcomes of the stem cell transplant and potentially lead to complete remission of the disease. However, it is important to weigh the risks and benefits of splenectomy for each individual patient and carefully monitor for any potential complications after surgery.

Timeline

Timeline of patient experiences before and after splenectomy:

Before splenectomy:

  • Diagnosed with myelofibrosis
  • Tried drug ruxolitinib to reduce spleen size
  • Spleen remains enlarged
  • Decision made to undergo splenectomy

During splenectomy:

  • Surgery performed, average hospital stay of 11 days
  • Some patients experience complications after surgery

After splenectomy:

  • Increase in white blood cells and platelets
  • Stem cell transplant performed around 2.6 months after spleen removal
  • All transplants successful, no severe infections or disease relapses
  • One patient dies from rare condition affecting small blood vessels
  • Seven patients alive and in complete remission from myelofibrosis

In conclusion, removing the spleen before a stem cell transplant could be a beneficial treatment option for patients with myelofibrosis.

What to Ask Your Doctor

  1. What are the risks and benefits of having a splenectomy before a stem cell transplant for myelofibrosis?

  2. How will removing my spleen affect my overall health and immune system?

  3. What is the recovery process like after a splenectomy?

  4. Are there any alternative treatment options to consider before deciding on a splenectomy?

  5. How will the spleen removal impact my eligibility for a stem cell transplant?

  6. What are the potential complications or side effects of having a splenectomy?

  7. How long will I need to wait before having a stem cell transplant after the spleen removal?

  8. How successful have previous patients been in achieving remission after a splenectomy and stem cell transplant?

  9. What follow-up care or monitoring will be needed after the procedure?

  10. Are there any long-term effects or considerations to be aware of after having a splenectomy?

Reference

Authors: Barabanshikova MV, Zubarovsky IN, Savrasov VM, Korolkov AJ, Baykov VV, Botina AV, Vlasova JJ, Moiseev IS, Darskaya EI, Morozova EV, Afanasyev BV. Journal: Hematol Oncol Stem Cell Ther. 2019 Sep;12(3):140-145. doi: 10.1016/j.hemonc.2019.03.001. Epub 2019 Apr 6. PMID: 30978308