Splenectomy in advanced chronic lymphocytics leukemia

Abstract

Forty chronic lymphocytic leukemia patients with splenomegaly were evaluated for splenectomy. Twenty were splenectomized. All but two normalized their hematocrit and all but one their platelet count. Satisfactory residual erythropoiesis as evaluated using ferrokinetics enabled prediction of a good response to splenectomy in 18 of 20 patients. The two patients who did not respond despite satisfactory residual erythropoiesis had a deteriorating blood count after splenectomy with progressive disease. The measurement of the splenic red cell volume predicted the minimal increase in hematocrit that could be expected after splenectomy. The transfusion need was abolished in 13 of 14 patients who needed red cell transfusions before splenectomy. Despite clinical improvement after the operation in all but two patients, splenectomized patients did not survive longer than nonsplenectomized patients, whether survival probability was calculated from the time of diagnosis or from the time of evaluation.

Cyclosporin A for the treatment of cytopenia associated with chronic lymphocytic leukemia

“…Using the same response criteria, the major response rate (good plus excellent) was 38% and 81%, respectively 28. Other series have reported a platelet improvement to ≥ 50 × 10 9 /L in 53–91% of patients, and hemoglobin improvements > 2–3 g/dL in 56–80% of patients 29–33. In the current series we report a major response rate (i.e., an increase of ≥ 50 × 10 9 /L in the platelet count and ≥ 3 g/dL in the hemoglobin level) of 62% for patients with thrombocytopenia and 63% for patients with anemia.…”

Chronic leukaemias: can they be cured? Part II: chronic lymphocytic leukaemia

“…Splenic irradiation has also been used and may confer marginally better benefit than chemotherapy in patients with advanced B‐CLL 21 . Splenectomy may also be indicated in such patients with advanced disease to reduce transfusion requirements, and until fairly recently used to be the treatment of choice for B‐HCL 22 , 23 .…”

Λοιμώδεις Επιπλοκές Της Θεραπείας Με Φλουνταραμπίνη Σε Αρρώστους Με Χρόνια Λεμφογενή Λευχαιμία

“…Η σπληνεκτομή χρησιμοποιείται σπάνια πια στην θεραπεία τηε νόσου. Η αυξημένη επίπτωση λοιμώξεων απο βακτηρίδια που φέρουν κάψουλα (encapsulated) στις-παλαιοτερεε μελε'τες• θα μπορούσε να αποδοθεί εν μερει στην σχετικά συχνή σπληνεκτομή που αποτελούσε μεροε τηε τότε θεραπεία της• ΧΛΛ(1,111). Εν τουτοις• δεν εχει μελετηθεί ειδικά ο κίνδυνοε λοιμώξεως-σε αρρώστους• με ΧΛΛ και σπληνεκτομή.Το τίμημα ωστόσο για την πρόοδο αυτή η'ταν η σημαντική' νοσηρότητα και θνητότητα απο σοβαρέ'?…”