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Splenectomy is used as the second line therapy in patients with immune thrombocytopenia (ITP). However, there is no parameter predicting splenectomy decision.

Bone marrow specimens were taken from 24 patients who were diagnosed with ITP and who had splenectomy (15 female, 9 male, mean age 50±16) before splenectomy and 30 patients who were diagnosed with ITP but did not have splenectomy (15 female, 15 male, mean age 52±19). c-mpl staining was carried out retrospectively. Immunohistochemical (IHC) staining using Avidin-Biotin complex system (ABC) was conducted. For IHC, dissections prepared from blocks were taken onto poly-L-lysine coated slides (MicroSlides Snowcoat X-tra, Surgipath, Richmond, IL, USA) and kept in an incubator at 37 °C overnight. Dissections were treated with IHC c-mpl (Santa Cruz/sc-13187) stain. Cytoplasmic and nuclear staining was observed in megakaryocytes using IHC c-MPL and vitamin D. Evaluation was made based on the intensity of the staining; i.e. negative (0), weak (1+), moderate (2+) and strong (3+) (1). All patients who had splenectomy were in chronic phase of the disease. The present study was supported as a Scientific Research Project by Adnan Menderes University (TPF-15027).

Table 1: c-mpl positivity in patients group who had and did not have splenectomy

Status of c-mpl in ITP is ambiguous. Significant level of positivity in patient group who did not have splenectomy might the useful for splenectomy indication.