Splenectomy in Leukemia and Leukosarcoma

Jh, Fisher; Cs, Welch; Dameshek, W

doi:10.1056/nejm195203272461301

Cited by 53 publications

(6 citation statements)

References 8 publications

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“…Two died within one month after splenectomy while still in the hospital. One of these deaths was due to myocardial infarction; the other was attributed to No. 4 MALIGNANT LYMPHOXIA OF THE SPLEEN -A/1117(1)117 ct rtl.…”

Section: Prognosismentioning

confidence: 99%

Malignant lymphoma of the spleen.A review of 49 cases in which the diagnosis was made at splenectomy

Ahmann

Kiely

Harrison

et al. 1966

Cancer

188

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A group of 49 Mayo Clinic patients in whom the original diagnosis of lymphoma was made at splenectomy is reported. Systemic symptoms and pain were the commonest complaints and peripheral blood cytopenias were the major abnormal laboratory findings. The correct diagnosis was suspected in almost half of the patients prior to surgery. The 5‐year survival rate for the entire group was 31%. The survival rate of 17 patients with localized lesions that were resected was considerably better than in those with residual tumor left after surgery. Patients of various histologic types of lymphoma with a follicular pattern of distribution tended to have a better prognosis than those with diffuse infiltration. The group with lymphocytic lymphoma had a 5‐year survival rate of 60%, considerably higher than that for patients with lesions of other histologic types.

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Section: Prognosismentioning

confidence: 99%

Malignant lymphoma of the spleen.A review of 49 cases in which the diagnosis was made at splenectomy

Ahmann

Kiely

Harrison

et al. 1966

Cancer

188

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“…Splenectomy as a form of treatment in chronic lymphocytic leukaemia (CLL) and other types of lym phoproliférative malignancies was first proposed at the end of the last century [4,14,17], and early reports emphasized the remarkable improvement observed in some patients thus treated [8,13]. The subsequent ad vent of anti-metabolites and alkylating agents repre sented a major advance in the pursuit of new forms of cancer therapy, and it seemed possible that CLL, a relatively 'benign' neoplasia, could be easily con trolled with single-agent chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Splenectomy in Advanced Chronic Lymphocytic Leukaemia

et al. 1987

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A group of 20 patients with stage C chronic lymphocytic leukaemia (CLL) and marked splenomegaly refractory to anti-leukaemia treatment was evaluated in relation to clinical course and survival after splenectomy, and compared with a control group of non-splenectomised CLL patients at the same disease stage. Patients in the former group showed a significant clinical improvement after splenectomy, being reallocated to, and maintained in, stages A (85%) or B (10%) for more than 24 months. Ten patients were still alive 24–135 months after splenectomy. The 10 deaths observed in the group of splenectomised patients occurred 4–69 months after surgery, due to disease progression and/or immunoblastic transformation (4 cases), infectious complications (3 cases) and unrelated causes (3 cases). Analysis of survival from diagnosis showed a significantly better prognosis for patients in the splenectomised group (median survival 10 years, as compared to 3.5 years for the control group). The same statistical difference, p < 0.001, with better life expectancy for splenectomised patients, was observed when the survival was calculated from the time of progression to stage C. These results strongly suggest a beneficial role for splenectomy in advanced CLL with significant splenomegaly, when the accumulation of resistant lymphoid cells precludes an adequate control of the disease by conventional forms of treatment.

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“…Moreover, the results have been questionable in the treatment o f reticuloendothelioses (Strumia et al 1966). Several authors have set up criteria applying to the indication for splenectomy (Welch & Dameshek 1950, Michel 1951, Fischer et al 1952, Whitby & Britton 1963. It has been emphasized, for instance, that patients with haemolysis, a hyperplastic bone marrow, and possibly thrombocytopenia or pancytopenia (hypersplenism) often respond to splenectomy by normalization of the peripheral blood picture.…”

mentioning

confidence: 99%

Splenectomy in Haematology Indications, Results, and Complications in 41 Cases

Christensen

Hansen

Kristensen

et al. 1970

Scandinavian Journal of Haematology

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The indications for, effect of, and immediate complications of splenectomy are reported on the basis of 41 patients followed for from 3 months to 3 years after the operation. There is a general indication for splenectomy in hereditary spherocytosis, but in other cases of haemolytic anaemia splenectomy appears to presuppose proof that the spleen is playing the main role in the erythrocyte sequestration. In chronic lymphatic leukaemia splenectomy may evidently be advised on the basis of fairly simple clinical findings: Disease activity that calls for treatment, e.g. weight loss, a tendency to sweating as well as anaemia, thrombocytopenia, combined with considerable splenomegaly as the predominant focus. The time of splenectomy should not be delayed as long as possible, as decisive items of risk appear to increase with the duration of the disease. For instance, pronounced splenomegaly gives rise to special problems, and long‐lasting cytostatic and corticoid medication as well as progression of the basic disease will increase the incidence of postoperative complications. Haemorrhage from the splenic bed and infection, most often with a pulmonary focus, were recorded as the most common operative complications. Their incidence was particularly high in operations on patients having chronic lymphatic leukaemia.

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Splenectomy in Leukemia and Leukosarcoma

Cited by 53 publications

References 8 publications

Malignant lymphoma of the spleen.A review of 49 cases in which the diagnosis was made at splenectomy

Malignant lymphoma of the spleen.A review of 49 cases in which the diagnosis was made at splenectomy

Splenectomy in Advanced Chronic Lymphocytic Leukaemia

Splenectomy in Haematology Indications, Results, and Complications in 41 Cases

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