{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T23:16:11Z","timestamp":1792278971306,"version":"4.4.0"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T00:00:00Z","timestamp":1538697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2 TR000136"],"award-info":[{"award-number":["KL2 TR000136"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In a 28\u2010year period, 39 (7%) patients with chronic myelomonocytic leukemia (CMML) (median age 66\u2009years, 64% male) underwent a splenectomy at our institution. Primary indications for splenectomy were refractory thrombocytopenia (36%), progressive spleen related symptoms (33%), emergent splenectomy for splenic rupture (21%), refractory anemia (8%), and prior to allogeneic stem cell transplant (3%). Eleven (28%) patients had anemia at the time of splenectomy, of which 3 (27%) were autoimmune. The median time to splenectomy from CMML diagnosis was 6 months (0\u201040); perioperative morbidity and mortality rates were 43% and 13%, while the median postsplenectomy survival was 25\u2009months (11\u201038). Durable remission in spleen related symptoms, thrombocytopenia, complications from splenic rupture, and anemia were achieved in 85%, 50%, 62%, and 21% of patients, respectively. Perioperative morbidity (<jats:italic>n<\/jats:italic>\u2009=\u200930) included infections\/sepsis in 6 (20%), intraabdominal bleeding in 4 (13%), venous thromboembolism (VTE) in 3 (10%), and acute lung injury in 2 (7%) patients. The median duration of hospital stay was 6 days (1\u201025), with 5 deaths occurring secondary to respiratory failure (<jats:italic>n<\/jats:italic>\u2009=\u20092), multiorgan dysfunction (<jats:italic>n<\/jats:italic>\u2009=\u20092) and hemorrhagic shock (<jats:italic>n<\/jats:italic>\u2009=\u20091). There was no difference in overall survival between CMML patients that underwent splenectomy, in comparison to those that did not. Unlike in myelofibrosis, portal hypertension was not an indication for splenectomy and no patients developed post\u2010splenectomy thrombocytosis. In conclusion, apart from being a lifesaving emergent modality in the event of splenic rupture, splenectomy has an important palliative role in patients with CMML, with significant and durable improvements in spleen related symptoms and refractory cytopenias.<\/jats:p>","DOI":"10.1002\/ajh.25246","type":"journal-article","created":{"date-parts":[[2018,8,14]],"date-time":"2018-08-14T03:54:20Z","timestamp":1534218860000},"page":"1347-1357","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Splenectomy in patients with chronic myelomonocytic leukemia: Indications, histopathological findings and clinical outcomes in a single institutional series of thirty\u2010nine patients"],"prefix":"10.1002","volume":"93","author":[{"given":"Prateek","family":"Pophali","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Horna","sequence":"additional","affiliation":[{"name":"Division of Hematopathology, Department of Laboratory Medicine Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terra L.","family":"Lasho","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christy M.","family":"Finke","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhett P.","family":"Ketterling","sequence":"additional","affiliation":[{"name":"Division of Hematopathology, Department of Laboratory Medicine Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9104-6172","authenticated-orcid":false,"given":"Naseema","family":"Gangat","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Nagorney","sequence":"additional","affiliation":[{"name":"Department of General Surgery Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4605-3821","authenticated-orcid":false,"given":"Ayalew","family":"Tefferi","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6998-662X","authenticated-orcid":false,"given":"Mrinal M.","family":"Patnaik","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,5]]},"reference":[{"key":"e_1_2_6_2_1","article-title":"Blast phase chronic myelomonocytic leukemia: Mayo\u2010MDACC collaborative study of 171 cases","author":"Patnaik MM","year":"2018","journal-title":"Leukemia"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24396"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-03-643544"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2018.1452212"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V95.7.2226"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24881"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2126(03)00006-7"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23846"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2013.88"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2014.125"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/bcj.2015.113"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24581"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-10-4149"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2012.753448"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-018-0121-1"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25104"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604935"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2013.09.003"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20504"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.revmed.2010.08.005"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e32834db4ee"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh136"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2016.05.013"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000365877"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2016.1243681"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2016.1169411"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.12393"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-06-440347"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2015.16"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31825dd4de"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.2012.04175.x"},{"key":"e_1_2_6_33_1","unstructured":"Mrinal PatnaikHA GuptaV SchillerG et al. Results from ongoing phase 1\/2 trial of SL\u2010401 in patient with relapsed\/refractroy CMML. European Hematology Association 2018; Stockholm."},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2016.02.009"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24939"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-03-491399"}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fajh.25246","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.25246","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T12:02:33Z","timestamp":1694779353000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.25246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,5]]},"references-count":35,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1002\/ajh.25246"],"URL":"https:\/\/doi.org\/10.1002\/ajh.25246","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,5]]},"assertion":[{"value":"2018-07-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}