For patients with significant pancytopenia due to splenic sequestration from hepatosplenomegaly, do you consider interventions to the spleen to improve counts?

In patients with significant cytopenias due to hypersplenism, for which underlying conditions would you consider spleen-directed interventions (e.g., splenectomy, embolization, or irradiation) to improve blood counts?

• Cirrhosis or noncirrhotic portal hypertension
• Myelofibrosis or other myeloproliferative neoplasms
• Thalassemia or other chronic hemolytic anemias
• Lymphoma or other hematologic malignancies
• Infiltrative or storage disorders (e.g., Gaucher disease)
• I never intervene solely to improve blood counts
• Other