title: Treatment of prolymphocytic leukemia.
abstract: Prolymphocytic leukemia is characterized by marked splenomegaly, distinctive cellular morphologic characteristics, and a poor clinical course. Five patients with typical PL were treated systematically with vincristine/prednisone, chlorambucil/prednisone, splenic irradiation, splenectomy, and other chemotherapy regimens. No patient responded to vincristine/prednisone. Two patients responded to chlorambucil/prednisone, and four patients had brief responses to splenic irradiation. Two patients underwent splenectomy, one of whom had a prolonged clinical remission. There were no complete remissions. No other chemotherapy combinations were of value. The median survival was 33 months. Recommendations are made to use chlorambucil/prednisone or splenic irradiation as initial treatment. Splenectomy should be considered in patients refractory to these modalities. The course of PL may be more protracted than originally reported.
mesh_terms: D000368:Aged; D002699:Chlorambucil / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007945:Leukemia, Lymphoid / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011241:Prednisone / Q000627:therapeutic use; D013154:Spleen / Q000528:radiation effects; D013156:Splenectomy; D013163:Splenomegaly; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D002699:Chlorambucil; D014750:Vincristine; D011241:Prednisone