title: Significance of splenomegaly in childhood acute lymphoblastic leukaemia in remission.
abstract: In 5 children with acute lymphoblastic leukaemia (ALL) splenomegaly occurred or persisted after induction of haematological remission. 3 patients underwent splenectomy but the spleen was free of leukaemia in each case; these patients relapsed and died 10 to 28 months after surgery. 2 patients who were not splenectomised are alive and free of leukaemia 2 and 6 years after splenomegaly was first noted; in 1 splenomegaly regressed after cessation of antileukaemic therapy. The isolated finding of splenomegaly in children with ALL in haematological remission does not necessarily indicate a relapse; instead, it is suggested that splenic enlargement may reflect an immunological process contributing to control the leukaemia and that removal of the spleen may be harmful.
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007945:Leukemia, Lymphoid / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D008297:Male; D012075:Remission, Spontaneous; D013154:Spleen / Q000276:immunology; D013156:Splenectomy / Q000009:adverse effects*; D013163:Splenomegaly / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology