Role of splenectomy in chronic lymphocytic leukaemia with massive splenomegaly and cytopenia

Leuk Lymphoma. 1992 May;7(1-2):131-4. doi: 10.3109/10428199209053612.

Abstract

Fourteen cases of chronic lymphocytic leukaemia (CLL) and massive splenomegaly associated with anaemia and/or thrombocytopenia (stage C) with or without mechanical distress underwent splenectomy. Eleven regressed to stage A and 2 to stage B. All 6 patients with mechanical distress were relieved of their symptoms. Among 13 patients with anaemia, haemoglobin (Hb) level was normalised in 3, improved in 8 and showed no change in 2 cases. Among 13 patients with thrombocytopenia, platelet count was normalised in 10, improved in 1 and was unchanged in 2 cases. Mean Hb level increased from 89 g/l to 125 g/l and mean platelet count from 77 x 10(9)/l to 241 x 10(9)/l (p < 0.001 for both). Duration of response lasted for a mean period of 42.1 (CI 20.8-63.5) months. Mean survival after splenectomy was 44.5 months (CI 21.2-67.7). There was no operative mortality but 4 patients had significant post-operative morbidity. It is concluded that splenectomy is beneficial in advanced cases of CLL with massive splenomegaly and cytopenia.

MeSH terms

  • Anemia / etiology*
  • Female
  • Hemoglobins / analysis
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / blood
  • Leukemia, Lymphocytic, Chronic, B-Cell / complications
  • Leukemia, Lymphocytic, Chronic, B-Cell / pathology
  • Leukemia, Lymphocytic, Chronic, B-Cell / surgery*
  • Leukocyte Count
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Platelet Count
  • Splenectomy*
  • Splenomegaly / etiology*
  • Splenomegaly / pathology
  • Thrombocytopenia / etiology*

Substances

  • Hemoglobins