No abstract

Six patients with thalassaemia major were treated by partial splenic embolisation as an alternative to splenectomy and followed up for five years. Results were compared with those in a matched control group of seven patients treated by splenectomy.All patients treated by partial splenic embolisation showed a reduction in blood transfusion requirements comparable with those in the controls and which remained unchanged over the five years. Serious infections that commonly occur in patients splenectomised for thalassaemia did not occur after embolisation, presumably owing to preservation of some immune function by the splenic remnant. By contrast with the change in platelet counts seen after splenectomy, platelet counts remained normal after partial splenic embolisation, so reducing the risk of thromboses. On the other hand, pre-existing leucopenia and thrombocytopenia were corrected after embolisation.It is concluded that partial splenic embolisation provides an alternative to splenectomy for thalassaemia major and is equally effective and much safer. IntroductionOverwhelming infections'-3 and pulmonary artery embolism leading to hypoxaemia4 may occur even long after splenectomy for hypersplenism in thalassaemia major. In an attempt to avoid these

Platelet aggregation was studied in 40 children with previously untreated ALL. The studies were performed in 5 groups: during the two-phase m-Ultiple drug induction therapy, the three phases of cyclic sequential maintenance therapy (6-MP, MTX and VCR/PRED pulses) and after cessation of chemotherapy (Klin. Padiat. 189: 89, 1977).There was a significant inhibition of the collagen-induced platelet aggregation (p <0. 001) during the two months' period of induction chemotherapy. By the use of ADP as platelet aggregating agent the impairment of function was less evident (p < 0. The alteration of platelet function persisted during the first cycle of maintenance therapy (6-MP) and reappeared regularly during the VCR/PRED pulses to a lesser degree (p

Patients with thalassemia who receive multiple blood transfusions are at risk for the acquired immunodeficiency syndrome. Peripheral blood lymphocyte subpopulations were studied in 22 multitransfused thalassemic patients; 10 patients were without splenectomy and 12 were studied after splenectomy. Both groups were negative for anti-HIV. Four additional patients who were found positive for anti-HIV and ten healthy controls were also included in this study. Patients without splenectomy compared to controls and to patients after splenectomy showed a significant decrease of both percentage (p less than 0.001) and absolute numbers (p less than 0.001) of Leu-7+ cells without significant abnormalities of T4/T8 ratio (1.56 +/- 0.4). Patients after splenectomy compared to controls and to patients without splenectomy showed a significant increase of the absolute numbers of lymphocytes and lymphocytes subsets T11+, T3+, T4+, T8+ and SmIg+ cells. In the seropositive patients for HIV only a significant increase of the absolute number of T8+ cells was observed while the T4/T8 ratio was 1.24 +/- 0.73. The decrease in the percentage of Leu-7+ cells in patients without splenectomy correlated inversely to the total amount of blood transfused. In conclusion patients with thalassemia had normal T4/T8 ratio and did not show the abnormal immunologic profile that has been reported in haemophiliacs.