Splenectomy in lymphoproliferative disorders: a report on 70 cases and review of the literature

Leuk Lymphoma. 1993 Jul;10(4-5):245-64. doi: 10.3109/10428199309148547.

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.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adult
  • Aged
  • Anemia, Hemolytic, Autoimmune / surgery
  • Combined Modality Therapy
  • Female
  • Humans
  • Leukemia / blood
  • Leukemia / classification
  • Leukemia / mortality
  • Leukemia / surgery
  • Leukemia / therapy
  • Lymphoma, Non-Hodgkin / mortality
  • Lymphoma, Non-Hodgkin / surgery
  • Lymphoproliferative Disorders / blood
  • Lymphoproliferative Disorders / mortality
  • Lymphoproliferative Disorders / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Remission Induction
  • Retrospective Studies
  • Splenectomy*
  • Survival Analysis
  • Treatment Outcome