Persistent thrombocytosis in β-thalassemia post-splenectomy: A STROBE-compliant retrospective cohort study at a Jordanian referral center.

Beta-thalassemia is a prevalent autosomal recessive hematological disorder characterized by defective β-globin chain production. Splenectomy is commonly performed in severe cases to alleviate transfusion dependency, but persistent post-splenectomy thrombocytosis poses significant clinical challenges. This Strengthening the Reporting of Observational Studies in Epidemiology-compliant retrospective cohort study included β-thalassemia major patients who underwent splenectomy at Al-Bashir Hospital between 2018 and 2024. Hematologic and biochemical parameters before and 1 year after surgery were compared using paired t tests after verifying data normality with the Shapiro-Wilk test (P > .05). A P value < .05 was considered statistically significant. Persistent thrombocytosis was observed in all patients, with mean platelet counts of 965.36 ± 413.50 × 109/L immediately after surgery, decreasing slightly to 843.23 ± 320.08 × 109/L at the 1-year follow-up. Hemoglobin levels significantly increased from 8.91 ± 0.96 g/dL pre-splenectomy to 9.65 ± 1.49 g/dL post-splenectomy. Blood transfusion requirements decreased by 42.49%, and transfusion intervals lengthened significantly, confirming the procedure's effectiveness in reducing transfusion burden. Ferritin levels declined, reflecting improved iron overload management. Nevertheless, adherence to postoperative medications, including aspirin and hydroxyurea, was suboptimal, potentially elevating thrombotic risk. Splenectomy in β-thalassemia major is associated with sustained hematologic improvement but persistent thrombocytosis. These findings underscore the importance of long-term platelet monitoring and strict adherence to antithrombotic prophylaxis to ensure optimal safety and clinical outcomes. Further multicenter studies are warranted to establish standardized monitoring and management protocols for this population.