Spiers A S, Baikie A G, Galton D A, Kaur J, Catovsky D, Goldman J M, Wiltshaw E, Lowenthal R M, Buskard N A
Lancet. 1975 Oct 4;2(7936):627-30. doi: 10.1016/s0140-6736(75)90113-0.
13 patients with chronic granulocytic leukaemia (C.G.L.) which was unsatisfactorily controlled underwent splenectomy. 3 out of 4 patients with hypersplenism did well, as did 5 out of 8 patients in whom the C.G.L. had undergone metamorphosis to a refractory phase. In a case of C.G.L. complicated by severe myelofibrosis the need for transfusion was reduced but survival was short. Splenectomy should be considered when C.G.L. in its chronic phase is complicated by hypersplenism, and may be considered as a part of the treatment after C.G.L. has undergone metamorphosis to a refractory phase. However, a favourable outcome is unlikely for patients over 65 years, and in the presence of coexistent illnesses, rapidly progressive metamorphosis to an acute phase, or severe bone-marrow failure from any cause. In C.G.L., elective splenectomy early in the chronic phase must be clearly distinguished from splenectomy performed at a later stage when the disease is not well controlled.
13例慢性粒细胞白血病（C.G.L.）病情控制不佳的患者接受了脾切除术。4例脾功能亢进患者中有3例情况良好，8例C.G.L.已转变为难治阶段的患者中有5例情况良好。在1例合并严重骨髓纤维化的C.G.L.病例中，输血需求减少，但生存期较短。当慢性期C.G.L.合并脾功能亢进时应考虑脾切除术，在C.G.L.转变为难治阶段后也可将其视为治疗的一部分。然而，65岁以上患者、存在并存疾病、迅速进展为急性期或因任何原因导致严重骨髓衰竭时，不太可能获得良好预后。在C.G.L.中，慢性期早期的择期脾切除术必须与疾病未得到良好控制的后期进行的脾切除术明确区分。
