The Effect of Splenic X-Irradiation on the Ferrokinetics of Chronic Leukemia with a Clinical Study

Abstract

The usefulness of splenic x-irradiation in the palliative treatment of chronic leukemia is illustrated by the results obtained in the treatment of 18 patients. This form of therapy was generally followed by reduction in organ size, improvement in blood levels, and control of associated anemia. Abnormalities of iron kinetics were defined in nearly all patients prior to therapy. A second ferrokinetic study was performed after remissions were induced by splenic irradiation. In the majority of patients, some evidence of increased red cell sequestration in the spleen could be demonstrated before therapy. The reaction of the erythropoietic tissue to this hemolytic process varied. In a number of patients with chronic lymphatic leukemia, there was an absolute hypoactivity. In the chronic myeloid group, erythropoiesis was either normal or slightly increased. In three cases of CLL with marked hemolytic activity, the erythropoietic activity was increased approximately twofold. However, in none of the anemic cases was erythropoiesis adequate to maintain a normal red cell mass. Extramedullary erythropoiesis was demonstrated in all patients of the myeloid group.

Serum erythropoietin in chronic lymphocytic leukaemia

“…This would imply that the cause of anaemia in CLL is not only depressed red cell production because of marrow involvement with malignant lymphocytes, but also increased haemolysis and/or splenic sequestration of red cells. Some ferrokinetic studies indicate that this might be the case (Awwad et al, 1967), but this remains to be demonstrated in a large series of patients.…”