Splenectomy in patients with agnogenic myeloid metaplasia: an analysis of 321 published cases

The available data on 321 published cases of splenectomy in agnogenic myeloid metaplasia were reviewed. Anaemia and thrombopenia were the most common indications for this operation. Patients reported after 1940 had a median postoperative survival of 13 months. Their postoperative mortality was 7.5% after 2 d and 25.7% after 3 months. The postoperative mortality was significantly higher when the weight of the spleen exceeded 2000 g, or in patients with platelet count less than 70 X 10(9)/l. The most common causes of death were infections (34.4%), cardiac or thromboembolic events (26.4%) and haemorrhage (17.6%). Leukaemic transformation was reported in 11.2% of the cases.