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The value of splenectomy in chronic lymphocytic leukemia
Author(s) -
Delpero J. R.,
Gastaut J. A.,
Letreut Y. P.,
Caamano A.,
MathieuTubia.,
Maraninchi D.,
SimonLejeune C.,
Mascret B.,
Blanc A. P.,
Sebahoun G.,
Guerinel G.,
Carcassonne Y.
Publication year - 1987
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19870115)59:2<340::aid-cncr2820590229>3.0.co;2-a
Subject(s) - medicine , splenectomy , chronic lymphocytic leukemia , value (mathematics) , leukemia , spleen , statistics , mathematics
Between January 1, 1980, and July 31, 1985, 168 patients were treated at our institution for chronic lymphocytic leukemia (CLL). Splenectomy was performed on 32 (23 men and 9 women). The mean age of these surgical patients was 59.4 years (range, 43–75). Twenty‐four patients had received chemotherapy and/or corticotherapy prior to surgery and 1 of these 24 also underwent splenic radiotherapy. The interval between diagnosis and splenectomy ranged from 1 to 108 months (mean, 33.6 months ± 28.6). Before splenectomy, 9 patients had platelet counts > 100,000/mm 3 (3 with normal counts), 18 had counts between 50,000 and 100,000/mm 3 , and 5 had < 50,000/mm 3 . Seven patients had anemia with hemoglobin levels < 10g/dl (3 associated with thrombocytopenia); in the other 25 patients, hemoglobin levels were between 10 and 11 g/dl in 12 (9 associated with thrombocytopenia) and > 11 g/dl in 13. All patients but one had splenomegaly (mean spleen weight 1780 g ± 938.7 range, 160–4300 g). One postoperative death was recorded. Postoperative morbidity occurred in 7 of 31 cases; severe infection was never observed. The average duration of hospitalization was 15 ± 4.7 days (range, 9–28). Twenty‐two of the 23 patients with thrombocytopenia less than 100,000/mm 3 had complete remission after splenectomy. One had a partial remission that was later completed by means of drug therapy. Two patients relapsed within 6 months and one after 32 months. All but two cases of anemia responded to splenectomy; one patient relapsed. In 15 of 31 surviving patients, further treatment was required within a few weeks or months after surgery. Five patients died at 8, 17, 22, 26, and 35 months, respectively. The other 26 patients are alive and well with a mean follow‐up of 34 months (range, 11–71 months). Splenectomy may be an effective treatment for CLL patients with splenomegaly, thrombocytopenia, and/or anemia. Cancer 59:340–345, 1987.