{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:36:11Z","timestamp":1792064171155,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,6,22]],"date-time":"2020-06-22T00:00:00Z","timestamp":1592784000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The role of splenectomy prior to hematopoietic stem cell transplantation (HSCT) is controversial. Only few studies compared the outcomes of splenectomized and nonsplenectomized children with transfusion\u2010dependent thalassemia (TDT) undergoing allogeneic HSCTs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was undertaken on a transplantation cohort of TDT patients; August 1987\u2010December 2014 to compare transplant outcomes between splenectomized and nonsplenectomized groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010six transplants in 86 TDT patients were analyzed. Sixteen patients were splenectomized before HSCTs. The splenectomized patients were significantly older (8.0 \u00b1 1.9 vs 4.7 \u00b1 0.6 years; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001), had larger livers and spleens (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001), and had a significantly shorter neutrophil engraftment time (absolute neutrophil count\u00a0&gt;\u00a0500\/mm<jats:sup>3<\/jats:sup>; 15.0 \u00b1 2.3 vs 19.2 \u00b1 1.3 days; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.004). Graft rejection occurred in 13.8% of the nonsplenectomized group, but not among the splenectomized patients. Though the splenectomized group's mortality rate was higher (25.0% vs 8.8%), this was not statistically significant (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.491). The main causes of death in both groups were severe infections. The five\u2010year overall survival (OS) rate was better for the nonsplenectomized group (91.78% vs 75.00%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.06).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although splenectomies prior to HSCT for the TDT patients in our cohort were associated with faster neutrophil engraftments and lower rejection rates, they did not produce significantly better OS or affect the mortality. As the splenectomies did not provide any distinct advantages, this procedure should not be routinely performed as a pre\u2010HSCT regimen for TDT patients with splenomegaly. Better pre\u2010HSCT preparation for TDT patients, including early and adequate blood transfusions to avoid splenomegaly, is recommended.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28483","type":"journal-article","created":{"date-parts":[[2020,6,22]],"date-time":"2020-06-22T13:18:26Z","timestamp":1592831906000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Impact of splenectomy on outcomes of hematopoietic stem cell transplantation in pediatric patients with transfusion\u2010dependent thalassemia"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3452-1894","authenticated-orcid":false,"given":"Kleebsabai","family":"Sanpakit","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital Mahidol University  Salaya Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nattee","family":"Narkbunnam","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital Mahidol University  Salaya Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5240-1071","authenticated-orcid":false,"given":"Jassada","family":"Buaboonnam","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital Mahidol University  Salaya Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chayamon","family":"Takpradit","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital Mahidol University  Salaya Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3162-1849","authenticated-orcid":false,"given":"Vip","family":"Viprakasit","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital Mahidol University  Salaya Thailand"},{"name":"Thalassemia Center, Faculty of Medicine Siriraj Hospital Mahidol University  Salaya Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bunchoo","family":"Pongtanakul","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital Mahidol University  Salaya 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