Humphrey J S, Conley C L
Medicine Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Am J Hematol. 1995 Apr;48(4):262-6. doi: 10.1002/ajh.2830480411.
Two patients with macroglobulinemia (monoclonal IgM in the serum) and massive splenomegaly were incapacitated by progressive disease refractory to standard chemotherapy. In each case, palliative splenectomy was followed by a prompt, complete, and unexpected clinical remission with disappearance from the serum of the monoclonal IgM component. One patient remains free of disease 12 years after splenectomy. The other patient remained free of detectable macroglobulinemia for 13 years after splenectomy. A review of the literature revealed other cases of remission of macroglobulinemia attributable to splenectomy alone. Data in humans and animals suggest that the spleen may facilitate IgM secretion by normal and malignant B lymphocytes. Splenectomy should be considered a possible treatment option for patients with massive splenomegaly and macroglobulinemia who progress on chemotherapy.
两名患有巨球蛋白血症（血清中存在单克隆IgM）且脾脏肿大的患者，因对标准化疗难治的进行性疾病而丧失活动能力。在每例病例中，姑息性脾切除术后均迅速、完全且意外地出现临床缓解，血清中的单克隆IgM成分消失。一名患者在脾切除术后12年无疾病复发。另一名患者在脾切除术后13年未检测到巨球蛋白血症。文献回顾显示了其他仅因脾切除术而使巨球蛋白血症缓解的病例。人和动物的数据表明，脾脏可能促进正常和恶性B淋巴细胞分泌IgM。对于化疗后病情进展的巨球蛋白血症且脾脏肿大的患者，应考虑将脾切除术作为一种可能的治疗选择。
