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Splenectomy in Chronic Myeloid Leukemia

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Requests for reprints should be addressed to Richard T. Silver, M.D.; Division of Hematology-Oncology, The New York Hospital-Cornell Medical Center, 525 East 68th St.; New York, NY 10021.

New York, New York

Ann Intern Med. 1978;89(5_Part_1):684-689. doi:10.7326/0003-4819-89-5-684
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We review splenectomy in chronic myeloid leukemia, emphasizing recent studies that have evaluated early splenectomy during the chronic phase of the disease. Despite current interest in splenectomy in chronic myeloid leukemia, uncontrolled clinical trials to date suggest that the operation during the early phase neither delays the onset of blastic transformation nor prolongs survival. Immediate operative mortality of splenectomy during the chronic phase is low, generally less than 1%. The morbidity of the procedure, however, remains formidable due to infectious and thromboembolic complications. Splenectomy during chronic-phase chronic myeloid leukemia permits easier control of the disease in patients who are thrombocytopenic due to busulfan toxicity or sensitivity. Splenectomy during the chronic phase may also palliate those patients who suffer from acute splenic events or massive splenomegaly. Splenectomy in blast-phase disease should be considered a heroic measure providing little benefit to most patients.





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