Morel P, Dupriez B, Gosselin B, Fenaux P, Estienne M H, Facon T, Jouet J P, Bauters F
Service des Maladies du Sang, CHU, Lille, France.
Cancer. 1993 Jan 1;71(1):207-15. doi: 10.1002/1097-0142(19930101)71:1<207::aid-cncr2820710132>3.0.co;2-0.
The outcomes were analyzed retrospectively of 59 cases of non-Hodgkin lymphoma (NHL) that included prominent splenic involvement (LPS). Forty-three patients had low-grade NHL, and 16 had intermediate or high-grade NHL. Forty of the 59 patients underwent splenectomy. Four patients died postoperatively before any treatment, and 10 others received no chemotherapy or radiation therapy. Twenty-nine splenectomized and 16 patients whose spleens were not removed received chemotherapy or radiation therapy. One or more cytopenias were present in 45 patients (77%). Five (18%) of the 28 patients who initially were cytopenic underwent splenectomies that did not correct their blood disorders. The median actuarial survival was 108 months in splenectomized patients and 24 months in those not treated surgically (P = 0.0001). For the 40 splenectomized patients, a normal postoperative platelet count, an initial hemoglobin level of 110 g/l or more, and a postoperative hemoglobin level 110 g/l or more were associated with prolonged survival. These results suggest that cytopenias are frequent in LPS and that their reversal is observed after early splenectomy in 82% of cases. The absence of cytopenia after early splenectomy is associated with prolonged survival.
对59例包括显著脾脏受累（LPS）的非霍奇金淋巴瘤（NHL）患者的结果进行了回顾性分析。43例患者为低度NHL，16例为中度或高度NHL。59例患者中有40例行脾切除术。4例患者术后未接受任何治疗即死亡，另有10例未接受化疗或放疗。29例行脾切除术的患者和16例未切除脾脏的患者接受了化疗或放疗。45例患者（77%）存在一种或多种血细胞减少。最初血细胞减少的28例患者中有5例（18%）接受了脾切除术，但并未纠正其血液疾病。脾切除患者的中位精算生存期为108个月，未接受手术治疗的患者为24个月（P = 0.0001）。对于40例行脾切除术的患者，术后血小板计数正常、初始血红蛋白水平≥110 g/l以及术后血红蛋白水平≥110 g/l与生存期延长相关。这些结果表明，血细胞减少在LPS中很常见，82%的病例在早期脾切除术后血细胞减少得到逆转。早期脾切除术后无血细胞减少与生存期延长相关。
