Value of surface counting in predicting response to splenectomy in haemolytic anaemia

Abstract

The principle of the method is based on the observation that destruction of red cells in an organ is manifested by progressive increase in radioactive counts over that organ relative to the count rate over other organs and over the heart, reflecting the radioactivity in the blood; thus assessment can be made of the role of the spleen relative to the liver in the destruction of erythrocytes. An accumulation of activity in the spleen suggests that splenectomy might be beneficial and the method has been considered to be a valuable aid in predicting response to splenectomy in the majority of patients with haemolytic anaemia. However, a number of false predictions have been reported by some authors (Schloesser et al, 1957;McCurdy and Rath, 1958;Veeger, Woldring, Van Rood, Eernisse, Leeksma, Verloop, and Nieweg, 1962;Ben-Bassat, Seligsohn, Leiba, Leef, Chaitchik, and Ramot, 1967;Allgood and Chaplin, 1967). These reports indicate the need for a clear understanding of the method before it is used in making a decision for or against splenectomy.

Sir John Dacie MD, FRS, FRCP, FRCPath

“…He maintained files on all the patients seen by him and contacted them regularly to review their progress. This enabled him to make careful note of their responses to steroid therapy and alkylating agents (Dacie, 1959) and the potential usefulness (or not) of splenectomy (Dacie & Chertkow, 1955; Chertkow & Dacie, 1956; Lewis, Szur & Dacie, 1960a; Ahuja et al , 1972). This work was continued by his colleague Worlledge (1982), and further extended by other distinguished serologists who had worked in Dacie's department, inter alia Blajchman (1971), Issit (1978), Petz and Garratty (1980), Worlledge and Blajchman (1972), Sirchia et al (1970), Hegde et al (1977).…”

The effect of blood transfusion on 51Cr-red blood cells surface-counting data in homozygous β-thalassaemia

“…On the other hand, "Cr-red blood cells surface-counting is used as an index for splenectomy in thalassaemic patients presenting with elevated transfusion requirements (Ahuja et al 1972). Unfortunately, these patients have usually to be submitted in blood transfusion during the erythrokinetics study.…”