Sadamori N, Sandberg A A
Cancer Genet Cytogenet. 1984 Aug;12(4):303-8. doi: 10.1016/0165-4608(84)90063-3.
The effect of splenectomy during the blastic phase (BP) in Philadelphia (Ph1) positive chronic myeloid leukemia (CML) was correlated with the chromosome findings during that phase of the disease. Fifty-three patients were divided into six groups on the basis of the chromosome findings and splenectomy; i.e., nonsplenectomized and splenectomized patients with only a Ph1 clone (PP/S- and PP/S+); nonsplenectomized and splenectomized patients with a clone containing only a Ph1 and another clone with karyotypic changes in addition to the Ph1 (AP/S- and AP/S+), and nonsplenectomized and splenectomized patients with only abnormal clone(s) containing karyotypic abnormalities in addition to the Ph1 (AA/S- and AA/S+). The percentage of patients with a good therapeutic response in each group was higher in splenectomized than nonsplenectomized patients. The median survival after the onset of BP was 171 days (5.7 months) in PP/S-, 167 days (5.6 months) in PP/S+, 136 days (4.5 months) in AP/S-, 183 days (6.1 months) in AP/S+, 23 days (0.8 months) in AA/S-, and 155 (5.2 months) in AA/S+. Statistically, there was a significant difference only between AA/S- and the other groups. These findings may indicate that splenectomy during the blastic phase could contribute to an improved tolerance to chemotherapy in each group and prolong the survival after the onset of BP in AA patients.
在费城（Ph1）阳性慢性髓性白血病（CML）的急变期（BP）进行脾切除术的效果与该疾病此阶段的染色体检查结果相关。根据染色体检查结果和脾切除术，将53例患者分为六组；即仅具有Ph1克隆的未行脾切除术和已行脾切除术的患者（PP/S-和PP/S+）；具有仅含Ph1的克隆以及除Ph1外还有核型改变的另一个克隆的未行脾切除术和已行脾切除术的患者（AP/S-和AP/S+），以及除Ph1外仅具有含核型异常的异常克隆的未行脾切除术和已行脾切除术的患者（AA/S-和AA/S+）。每组中治疗反应良好的患者百分比，已行脾切除术的高于未行脾切除术的患者。BP期发病后的中位生存期在PP/S-组为171天（5.7个月），PP/S+组为167天（5.6个月），AP/S-组为136天（4.5个月），AP/S+组为183天（6.1个月），AA/S-组为23天（0.8个月），AA/S+组为155天（5.2个月）。统计学上，仅AA/S-组与其他组之间存在显著差异。这些发现可能表明，在急变期进行脾切除术可有助于提高每组对化疗的耐受性，并延长AA患者BP期发病后的生存期。
