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Letters to the Editor
decision of the treating physician, and therefore misclas- sification cannot be ruled out. However, the high fre- quency of response found herein suggests misclassifica- tion is unlikely and may not have impacted the results. Lastly, there was no specific protocol attached to the reg- istry, and care of the patient was left to the discretion of the clinician, thus reflecting general practice.
In conclusion, splenectomy is a very effective approach for the management of selected children with primary ITP as evidenced by platelet count recovery. Although low, the risk of adverse events both peri-operative and in the long-term should be carefully considered when indi- cating this therapeutic modality. The only predictor of response available prior to indication of splenectomy is patient age; the older the patient, the higher the odds of response.
Maria L. Avila,1,2 Nour Amiri,1 Eleanor Pullenayegum,2 Victor Blanchette,1 Paul Imbach3 and Thomas Kühne4 on behalf of the Intercontinental Cooperative ITP Study Group
1Department of Pediatrics, University of Toronto, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada; 2Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; 3Medical Faculty, University of Basel, Switzerland and 4UKBB Universitäts-Kinderspital, Oncology/Hematology, Basel, Switzerland
Correspondence:
THOMAS KUEHNE - thomas.kuehne@ukbb.ch
doi:10.3324/haematol.2019.236737
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