Chromosome changes and splenectomy in Ph1-positive chronic myeloid leukemia. I. Predictive parameters in the blastic phase.

The effects of splenectomy in the blastic phase (BP) of Philadelphia (Ph1)-positive chronic myeloid leukemia (CML) were correlated with the chromosome findings at the BP. The 53 patients studied were divided into four groups on the basis of the chromosome findings in the bone marrow and/or blood and whether splenectomy was performed after the onset of the BP, i.e., patients with only a Ph1 clone with or without splenectomy and those with abnormal clones containing karyotypic abnormalities in addition to Ph1 with or without splenectomy. Statistical analyses showed that splenectomy for patients with abnormal clones in addition to Ph1 at the BP affected positively both median survival and percentage of patients with a good therapeutic response and that splenectomy in patients with only a Ph1 clone contributed to an improvement in the tolerance to chemotherapy.