Early splenectomy and polychemotherapy versus polychemotherapy alone in chronic myeloid leukemia

Baccarani, Michele; Corbelli, Giovanna; Tura, S; Fiacchini, M; Gobbi, Marco; Gugliotta, Luigi; Lauria, F.; Ricci, Paolo F.; Zaccaria, Alfonso; Mandelli, Franco; Alimena, Giuliana; Papa, G; Annino, Luciana; Guglielmi, Guido; Salinas, F. Beau; Mf, Martelli; Tonato, Maurizio; Soldani, M.; Sandre, G. De; Cetto, Gian Luigi; Pizzolo, Giovanni; Perona, G.; Cataldo, F; Panzacchi, G; Giustolisi, Rosario; Musso, R; Raimondo, Vincenzo; Cacciola, Emma; Cajozzo, A; Marco, Pietro Di; Citarrella, P; Porcellini, A; Izzi, T; Manna, Angela La; Lucarelli, G; Ferrini, Pierluigi Rossi; Leoni, Franco; Salti, F.; Bosisio, M.; Lanzi, E.; Dinelli, C. A.; Guglielmo, R Di; Miliani, A; Torlontano, G; Geraci, L; Palka, Giandomenico; Bruzzese, Laurie; Abbadessa, Antonio; Nappi, Giuseppe; Rizzoli, Vittorio; Delsignore, A.; Sansoni, Paolo; Carnevali, Cristina; Bonati, Antonio; Quarantelli, C.; Monjardini, S.; Bajetta, E.; Buzzoni, Roberto; Broccia, G; Alberti, Antonio; Magro, Saverio; Battista, R; Barbui, Tiziano; Dini, E; Grignani, F; Liberati, Marina; Allegra, Alessandro

doi:10.1016/0145-2126(81)90073-4

Cited by 23 publications

(2 citation statements)

References 23 publications

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“…Whereas there are no recent data supporting these hypotheses, several years ago it was reported that spleen Ph ϩ cells were somehow different from marrow and blood Ph ϩ cells in terms of their kinetic properties and cytogenetic patterns. 24,25 Although 3 studies failed to confirm the clinical benefits of early splenectomy, [26][27][28] it may now be appropriate to revisit the role of the spleen, investigating the composition and the structure of the splenic microenvironment with particular attention to stem cell niches and the conditions under which Ph ϩ stem and progenitor cells proliferate, differentiate, and mature in the spleen.…”

Section: Discussionmentioning

confidence: 99%

Predicting complete cytogenetic response and subsequent progression-free survival in 2060 patients with CML on imatinib treatment: the EUTOS score

Hasford

Baccarani

Hoffmann

et al. 2011

Blood

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417

340

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The outcome of chronic myeloid leukemia (CML) has been profoundly changed by the introduction of tyrosine kinase inhibitors into therapy, but the prognosis of patients with CML is still evaluated using prognostic scores developed in the chemotherapy and interferon era. The present work describes a new prognostic score that is superior to the Sokal and Euro scores both in its prognostic ability and in its simplicity. The predictive power of the score was developed and tested on a group of patients selected from a registry of 2060 patients enrolled in studies of first-line treatment with imatinib-based regimes. The EUTOS score using the percentage of basophils and spleen size best discriminated between high-risk and lowrisk groups of patients, with a positive predictive value of not reaching a CCgR of 34%. Five-year progression-free survival was significantly better in the lowthan in the high-risk group (90% vs 82%, P ‫؍‬ .006). These results were confirmed in the validation sample. The score can be used to identify CML patients with significantly lower probabilities of responding to therapy and survival, thus alerting physicians to those patients who require closer observation and early intervention. (Blood. 2011;118(3):686-692)

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Section: Discussionmentioning

confidence: 99%

Predicting complete cytogenetic response and subsequent progression-free survival in 2060 patients with CML on imatinib treatment: the EUTOS score

Hasford

Baccarani

Hoffmann

et al. 2011

Blood

Self Cite

417

340

View full text Add to dashboard Cite

show abstract

“…Many reports attributing value to splenectomy for this condition have been anecdotal. However, several recent nonrandomized comparisons of operation versus no operation early in the chronic phase of CGL have shown that splenectomy does not delay progression from the chronic to the blastic phase and does not prolong survival [9,10]. In a recent prospective trial, similar conclusions were reached [11].…”

Section: Leukemiamentioning

confidence: 77%

Splenectomy for splenomegaly and secondary hypersplenism

Coon

1985

World j. surg.

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Splenomegaly and secondary hypersplenism may be associated with acute and chronic infections, autoimmune states, portal hypertension or splenic vein thrombosis, and a number of infiltrative and neoplastic conditions involving the spleen. Our experience and that of others with these various conditions demonstrates that the decision to perform splenectomy should be based on well-defined and often strictly limited indications. Except for idiopathic splenomegaly, the presence and severity of secondary hypersplenism or severely symptomatic splenomegaly should be well documented. In each case, the potential for palliation and known mean duration of expected response must be weighed against the increased morbidity and mortality of splenectomy (as compared to operation for "primary" hypersplenism).

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Results of a prospective randomized trial of early splenectomy in chronic myeloid leukemia. The italian cooperative study group on chronic myeloid leukemia

Baccarani

1984

Cancer

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The role of early splenectomy in the management of chronic myeloid leukemia (CML) was investigated in a multicentric study with 21 contributing Hospitals. One hundred eighty‐nine patients younger than 66 years of age and previously untreated, were first seen between November 1974 and May 1977, were randomized to splenectomy or to nonsplenectomy, were given the same chemotherapy (busulfan, and courses of arabinosyl cytosine, 6‐thioguanine, and daunomycin), and were followed up for more than 5 years. Median survival was 45 months. No relationship of splenectomy to survival length could be shown either in the whole series, or in several subgroups that were selected according to presentation features and stage classification. Thromboembolic and vascular accidents were more frequent in the splenectomy group, and this was associated with more difficult control of platelet count. Early splenectomy is not recommended for treatment of CML.

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Early splenectomy and polychemotherapy versus polychemotherapy alone in chronic myeloid leukemia

Cited by 23 publications

References 23 publications

Predicting complete cytogenetic response and subsequent progression-free survival in 2060 patients with CML on imatinib treatment: the EUTOS score

Predicting complete cytogenetic response and subsequent progression-free survival in 2060 patients with CML on imatinib treatment: the EUTOS score

Splenectomy for splenomegaly and secondary hypersplenism

Results of a prospective randomized trial of early splenectomy in chronic myeloid leukemia. The italian cooperative study group on chronic myeloid leukemia

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