Abstract |
Between February, 1970 and September, 1991, we performed splenectomies on 70 patients with chronic lymphoproliferative disorders including primary leukemias: 19 B-cell chronic lymphocytic leukemia, 1 B-cell prolymphocytic leukemia, 22 hairy cell leukemias, 4 large granular lymphocytic leukemias, 1 T-cell prolymphocytic leukemia, and non-Hodgkin's lymphomas (NHL): 10 splenic lymphomas with villous lymphocytes, 4 follicular lymphomas, 5 mantle cell lymphomas, 3 lymphoplasmacytic and 1 large cell NHL. The primary indications for surgery in this series were therapy-resistant disease (40%) and therapeutic splenectomy (38%). Postsplenectomy, 70% of patients had a complete hematological response, 23% had a partial response, and 7% were nonresponsive. Median treatment-free survival correlated with the hematologic response postsplenectomy and the underlying diagnosis. Better treatment-free survivals were seen in patients with lesser degrees of anemia and thrombocytopenia. Overall, improvements were more pronounced in the B-cell than in the T-cell disorders. Indications for further therapy, postoperative morbidity and mortality, and survival times are discussed along with a review of the literature. These findings advocate a continuing role for splenectomy in symptomatic lymphoid malignancies running with splenomegaly and hypersplenism.
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Authors | J E Coad, E Matutes, D Catovsky |
Journal | Leukemia & lymphoma
(Leuk Lymphoma)
Vol. 10
Issue 4-5
Pg. 245-64
(Jul 1993)
ISSN: 1042-8194 [Print] United States |
PMID | 8220125
(Publication Type: Comparative Study, Journal Article, Review)
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Topics |
- Adult
- Aged
- Anemia, Hemolytic, Autoimmune
(surgery)
- Combined Modality Therapy
- Female
- Humans
- Leukemia
(blood, classification, mortality, surgery, therapy)
- Lymphoma, Non-Hodgkin
(mortality, surgery)
- Lymphoproliferative Disorders
(blood, mortality, surgery)
- Male
- Middle Aged
- Postoperative Complications
- Remission Induction
- Retrospective Studies
- Splenectomy
- Survival Analysis
- Treatment Outcome
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