Role of splenectomy in chronic lymphocytic leukaemia with massive splenomegaly and cytopenia.
Fourteen cases of chronic lymphocytic leukaemia (CLL) and massive splenomegaly associated with anaemia and/or thrombocytopenia (stage C) with or without mechanical distress underwent splenectomy. Eleven regressed to stage A and 2 to stage B. All 6 patients with mechanical distress were relieved of their symptoms. Among 13 patients with anaemia, haemoglobin (Hb) level was normalised in 3, improved in 8 and showed no change in 2 cases. Among 13 patients with thrombocytopenia, platelet count was normalised in 10, improved in 1 and was unchanged in 2 cases. Mean Hb level increased from 89 g/l to 125 g/l and mean platelet count from 77 x 10(9)/l to 241 x 10(9)/l (p < 0.001 for both). Duration of response lasted for a mean period of 42.1 (CI 20.8-63.5) months. Mean survival after splenectomy was 44.5 months (CI 21.2-67.7). There was no operative mortality but 4 patients had significant post-operative morbidity. It is concluded that splenectomy is beneficial in advanced cases of CLL with massive splenomegaly and cytopenia.
Majumdar
G
G
Division of Haematology, UMDS, St. Thomas' Campus, London, England.
Singh
A K
AK
D000740:Anemia / Q000209:etiology*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood / Q000150:complications / Q000473:pathology / Q000601:surgery*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010976:Platelet Count; D013156:Splenectomy; D013163:Splenomegaly / Q000209:etiology* / Q000473:pathology; D013921:Thrombocytopenia / Q000209:etiology*
D006454:Hemoglobins