Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.


Role of splenectomy in the treatment of myelodysplastic syndromes with peripheral thrombocytopenia: a report on six cases


Thrombocytopenia is generally of central origin in MDS, but can be due to peripheral platelet destruction in some cases. We studied platelet lifespan in 61 MDS cases with platelets <70000/mm3 and marrow blasts <10%. Nine of them (15%) had a major platelet lifespan reduction (<3.5 days), and were considered for splenectomy. Three of them were not splenectomized due to rapid death, patient refusal and older age plus liver predominance of platelet sequestration, respectively. The remaining six patients (two females and four males, median age 50 years, range 32 to 65) were splenectomized 3 to 21 months after diagnosis. Before splenectomy, five of them had RA and one had CMML. Platelets counts ranged from 5000 to 30000/mm3 and did not durably respond to other treatments. Three of the patients has a relapse of platelet counts, concomitantly required platelet transfusion due to recurrent blending, whereas three had anemia (two required erythrocyte transfusion) and four had neutropenia. Three months after surgery, platelet counts ranged from 55000 to 160000/mm3 (>100000/mm3 in four cases), no patient required platelet or erythrocyte transfusion, but there was no effect on neutrophil counts. Three patients had a relapse of platelet counts, concomitant with progression to AML in two of them, whereas the third relapsing case achieved normal platelet counts with further danazol. One patient died with normal platelet counts 12 months after splenectomy (from sepsis, probably related to neutropenia rather than splenectomy). Two patients remained with normal platelet counts 10 and 52 months after surgery. Our findings suggest that the mechanism of thrombocytopenia should be studied more often in ‘low risk’ MDS (ie with low bone marrow blast counts) with thrombocytopenia, as about 15% of them appear to have peripheral platelet destruction. Some of those patients may benefit from splenectomy.

This is a preview of subscription content

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DA, Gralnick HR, Sultan C . Proposals for the classification of the myelodysplastic syndromes Br J Haematol 1982 51: 189–199

    CAS  Article  Google Scholar 

  2. Fenaux P . Myelodysplastic syndromes Hematol Cell Ther 1996 38: 363–380

    CAS  Article  Google Scholar 

  3. Chabannon C, Molina L, Pegourie-Bandelier B, Bost M, Leger J, Hollard D . A review of 76 patients with myelodysplastic syndromes treated with danazol Cancer 1994 73: 3073–3080

    CAS  Article  Google Scholar 

  4. Catalano L, Selleri C, Montuori N, Fratellanza G, Notaro R, Fontana R, Formisano S, Rotoli B . Danazol for myelodysplastic syndromes Br J Haematol 1993 85: 230–231

    CAS  Article  Google Scholar 

  5. Stadtmauer EA, Cassileth PA, Edelstein M, Abrahm J, Schreiber AD, Nowell PC, Cines DB . Danazol treatment of myelodysplastic syndromes Br J Haematol 1991 77: 502–508

    CAS  Article  Google Scholar 

  6. Wattel E, Cambier N, Caulier MT, Sautiere D, Bauters F, Fenaux P . Androgen therapy in myelodysplastic syndromes with thrombocytopenia: a report on 20 cases Br J Haematol 1994 87: 205–208

    CAS  Article  Google Scholar 

  7. Hebbar M, Kaplan C, Caulier MT, Wattel E, Morel P, Wetterwald M, Bauters F, Fenaux P . Low incidence of specific anti-platelet antibodies detected by the MAIPA assay in the serum of thrombocytopenic MDS patients and lack of correlation between platelet autoantibodies, platelet lifespan and response to danazol therapy Br J Haematol 1996 94: 112–115

    CAS  Article  Google Scholar 

  8. Fenaux P, Caulier MT, Hirschauer MC, Beuscart R, Goudemand J, Bauters F . Re-evaluation of the prognostic factors for splenectomy in chronic idiopathic thrombocytopenic purpura (ITP): a report on 181 cases Eur J Haematol 1989 42: 259–264

    CAS  Article  Google Scholar 

  9. Greenberg P, Cox C, LeBeau MM, Fenaux P, Morel P, Sanz G, Sanz M, Vallespi T, Hamblin T, Oscier D, Ohyashiki K, Toyama K, Aul C, Mufti G, Bennett J . International scoring system for evaluating prognosis in myelodysplastic syndromes Blood 1997 89: 2079–2088

    CAS  PubMed  Google Scholar 

  10. Morel-Kopp MC, Kaplan C . Modification of the MAIPA technique to detect and identify anti-platelet glycoprotein autoantibodies Platelets 1994 5: 285–293

    Google Scholar 

  11. Gonzalez C, Majado MJ, Funes C, Sanchez A . Influencia desfavorable de la esplenectomia sobre un SMD de larga evolution. (Unfavorable effect of splenectomy on a myelodysplastic syndrome with a prolonged course) Sangre (Barc) 1993 38: 251–252

    CAS  Google Scholar 

  12. Mitsutani S, Kohriyama T, Kamio M, Saitoh T . Isolated thrombocytopenia as presenting symptoms of myelodysplastic syndromes Rinsho Ketsueki 1987 28: 945–950

    CAS  PubMed  Google Scholar 

  13. Kraus MD, Bartlett NL, Fleming MD, Dorfman DM . Splenic pathology in myelodysplasia: a report of 13 cases with clinical correlation Am J Surg Pathol 1998 22: 1255–1266

    CAS  Article  Google Scholar 

  14. Speck B, Tichelli A, Widmer E, Harder F, Kissling M, Wursch A, Stebler Gysi C, Signer E, Bargetzi M, Orth B, Gratwohl A, Nissen C . Splenectomy as an adjuvant measure in the treatment of severe aplastic anaemia Br J Haematol 1996 92: 818–824

    CAS  Article  Google Scholar 

  15. Barosi G, Ambrosetti A, Centra A, Falcone A, Finelli C, Foa P, Grossi A, Guarnone R, Rupoli S, Luciano L, Petti MC, Pogliani E, Russo D, Ruggeri M, Quaglini S . Splenectomy and risk of blast transformation in myelofibrosis with myeloid metaplasia. Italian Cooperative Study Group on Myeloid with Myeloid Metaplasia Blood 1998 91: 3630–3636

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

Reprints and Permissions

About this article

Cite this article

Bourgeois, E., Caulier, M., Rose, C. et al. Role of splenectomy in the treatment of myelodysplastic syndromes with peripheral thrombocytopenia: a report on six cases. Leukemia 15, 950–953 (2001).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • myelodysplastic syndromes
  • thrombocytopenia
  • splenectomy

Further reading


Quick links