The available data of 338 cases of splenectomy in agnogenic myeloid metaplasia published since 1940 were retrieved from the literature and analysed. Postoperative survival was significantly shorter in patients with anaemia, massive splenomegaly or elevated serum alkaline phosphatase. Younger age or normal platelet counts were associated with a longer postoperative survival than that in older patients and in patients with low platelet counts respectively. The shortest median postoperative survival was found in: patients in whom serum alkaline phosphatase exceeded twice the upper limit of the normal; patients with anaemia (less than 10 g/dl haemoglobin) and massive splenomegaly (above 3 kg); and patients with anaemia and a splenic weight less than one kg.
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