OBJECTIVES: Immune thrombocytopenia (ITP) is associated with a risk of spontaneous and excessive bleeding. Among the treatment options are medical therapies and splenectomy – a major intervention with lifelong consequences for the patient. Both ITP and ITP-treatment may impact health-related quality of life (HrQoL); therefore, a literature search was conducted to assess HrQoL of splenectomized compared to non-splenectomized ITP patients. METHODS: A targeted literature search was conducted via Ovid (Medline, Embase, and Cochrane) in September 2014. Search strings were based on PICO-criteria (Patient, Intervention, Comparison and Outcomes). Inclusion criteria were: studies of adult patients with ITP that contained information on HrQoL; clinical trials, RCTs, meta-analyses, observational trials, retrospective studies or systematic reviews; manuscripts and congress abstracts in English or German language. RESULTS: The search identified 148 potentially relevant publications. After removing duplicates, 120 titles and abstracts were screened. Following the title/abstract screening, a full text screening (n=21) identified six relevant publications. HrQoL was assessed in these six publications using generic (SF-36, n=2; EQ-5D, n=1) and disease-specifc (ITP-PAQ, n=4) instruments. Two studies using generic instruments reported no difference in HrQoL between splenectomized and non-splenectomized patients. Of the four studies using the ITP-PAQ, two reported no difference and two found worse HrQoL in splenectomized versus non-splenectomized patients. In the only study that included both generic (SF-36, EQ-5D) and ITP-specific measures, results were inconsistent, as they varied in outcomes. Overall detailed results were not always provided and HrQoL was not reported according to response to therapy in any study. CONCLUSIONS: The impact of splenectomy on HrQoL in patients with ITP is inconclusive and inconsistently reported in the literature, due to use of different instruments, diverse patient characteristics, and pooling of data among responding and non-responding patients. Further studies are needed to address this question within clearly-defined populations.