Hi All,
I am a 33 years old male who was diagnosed with ITP (Immune Thrombocytopenia) in April 2022 and since then I have undergone multiple lines of treatment for 3+ years as shown in chronological order below:
1. Prednisone (60mg to 5mg) for 8 weeks.
2. Rituximab IV (Truxima - 720mg dose) for 4 weeks.
3. Promacta (50mg, 75mg) for 5 weeks.
4. Nplate (1mcg/kg to 10mcg/kg) for 3 years from June 2022 till June 2025.
5. Doptelet (20mg/day to 40mg/day) for 5 weeks from June 2025 till July 2025.
6. Tavalisse (100mg - 2 per day) for 3 weeks in August 2025.
7. Received 1 unit of Platelet Transfusion (Plateletpheresis) on August 26th, 2025 as my platelet count dropped to 9000 on August 25th, 2025.
8. Took Dexamethasone 4mg (10 per day) tablets for 4 days from August 26th, 2025 till August 29th, 2025.
9. Resumed back to Nplate (10mcg/kg) on September 2nd, 2025 as it was the most effective treatment to keep my platelet count close to and above 50k for most of the time.
My most recent platelet count on September 2nd, 2025 is 16000.
At this juncture, my hematologist is recommending for Splenectomy as the next step as different lines of treatment have failed and Nplate was not helping with remission effectively even though it's keeping my platelet count above 50k for most of the time. I don't have any active symptoms of bleeding anywhere, apart from slight body weakness or tiredness when my platelet count is low. Also, my other blood parameters are all normal except for the platelet count.
I understand that Splenectomy has only 70% to 80% success rate for platelet remission and post Splenectomy, I may become more susceptible to different bacterial infections and I need to take frequent vaccinations to protect against them.
Considering I don't have any active bleeding symptoms and the risks tied to Splenectomy, I would kindly need your help in reviewing my treatment, platelet count data and help provide any possible next steps of treatment without Splenectomy.
Looking forward to hearing from you. Thank you and have a great day !
Topic Author