Schreiber D P, Jacobs C, Rosenberg S A, Cox R S, Hoppe R T
Int J Radiat Oncol Biol Phys. 1985 Jan;11(1):31-6. doi: 10.1016/0360-3016(85)90359-1.
Thirty-four patients with Hodgkin's disease and non-Hodgkin's lymphoma underwent therapeutic splenectomies to improve hematologic tolerance for chemotherapy. The mean age was 40 years; there were 16 males and 18 females. Fourteen had Hodgkin's disease, 19 had non-Hodgkin's lymphoma, and 1 had malignant histiocytosis. Nineteen had palpable splenomegaly, 19 had marrow involvement and 20 had splenic involvement by lymphoma. The following data were analyzed before and after splenectomy: mean white blood cell count (WBC) and platelet count on planned first day of cycle, delay ratio of chemotherapy delivery and percent maximal dose rate. Thirteen patients had non-Hodgkin's lymphoma, splenomegaly and positive bone marrow and showed significant benefit in all of the aforementioned parameters. Of the patients with prior irradiation, only those who completed their radiation greater than six months prior to splenectomy showed benefit. Ten patients had Hodgkin's disease, negative bone marrow and no splenomegaly. This group showed significant improvement in mean platelet count but more limited benefit in delay ratio and percent maximal dose rate. Thus, selected patients with lymphoma who are experiencing delays in chemotherapy because of poor count tolerance may benefit from splenectomy.
34例霍奇金病和非霍奇金淋巴瘤患者接受了治疗性脾切除术，以提高对化疗的血液学耐受性。平均年龄为40岁；男性16例，女性18例。14例患有霍奇金病，19例患有非霍奇金淋巴瘤，1例患有恶性组织细胞增多症。19例可触及脾肿大，19例有骨髓受累，20例有淋巴瘤脾脏受累。在脾切除术前和术后分析了以下数据：计划周期第一天的平均白细胞计数（WBC）和血小板计数、化疗给药延迟率和最大剂量率百分比。13例非霍奇金淋巴瘤患者有脾肿大且骨髓阳性，在上述所有参数方面均显示出显著益处。在先前接受过放疗的患者中，只有那些在脾切除术前六个月以上完成放疗的患者显示出益处。10例霍奇金病患者骨髓阴性且无脾肿大。该组患者的平均血小板计数有显著改善，但在延迟率和最大剂量率百分比方面的益处较为有限。因此，因血细胞计数耐受性差而化疗延迟的部分淋巴瘤患者可能从脾切除术中获益。
