Chronic Granulocytic Leukaemia: Effect of Elective Splenectomy on the Course of Disease. Issue 5951 (25th January 1975)

• Record Type: Journal Article
• Authors: Spiers, A. S. D.; Baikie, A. G.; Galton, D. A. G.; Richards, H. G. H.; Wiltshaw, E.; Goldman, J. M.; Catovsky, D.; Spencer, J.; Peto, R.
• Is Part Of: BMJ. Volume 1:Issue 5951(1975)
• Page Start: 175
• Page End: 179
• Publication Date: 1975-01-25
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Periodicals; 610
• DOI: 10.1136/bmj.1.5951.175
• Languages: English
• ISSNs: 0007-1447

Abstract

Abstract : Conventional treatment by drugs or irradiation produces little prolongation of life in patients with chronic granulocytic leukaemia (C.G.L.) because the onset of metamorphosis of the disease from a chronic to an acute or subacute leukaemic process is not substantially postponed. Isolated clinical observations as well as both cytogenetic and cytokinetic evidence suggest that the spleen may play a special though not exclusive role in the development of undifferentiated cell clones which lead to metamorphosis of C.G.L. The results of a study of elective splenectomy during the chronic phase of the disease are reported. Twenty-six patients with C.G.L. underwent splenectomy during clinical remission of their disease, and there were no deaths after the operation. Twenty-one patients were alive at the time of writing, two of them eight years after splenectomy. Five cases of metamorphosis of C.G.L. to a refractory phase occurred whereas 10 would have been expected, a significant difference. After the onset of metamorphosis the quality of life was better in splenectomized than in non-splenectomized patients. These results show that splenectomy is a reasonable and safe procedure in C.G.L., and its apparently beneficial effects on prognosis justify a larger controlled clinical trial.