[Benefits of splenectomy in the treatment of chronic leukemia]. / Beneficio de la esplenectomía en el tratamiento de las leucemias crónicas.

ABSTRACT

Both chronic myeloid leukemias (CML) and lymphoid chronic leukemias (LCL) affect the spleen provoking the appearance of symptoms due to the size of the spleen or the sequestration of blood cells. Splenectomy has been utilized to prevent these conditions. We have a series of 12 patients suffering (CML) and 7 suffering LCL with a mean age of 34.4 and 60.14 respectively. All our patients underwent surgery since their splenomegaly did not respond to chemotherapy on radiotherapy with a general worsening of the patients condition. The postsurgery morbidity was greater in patients suffering CML than in those suffering LCL. The most important complications were pulmonary, followed by hemorrhages in the LCL group, and by the presence of fever of unknown origin in the splenectomized LCL patients. There were no fatalities in our series. Clinical and hematological improvement was evident in LCL patients, with increasing hematocrit and platelet number (100% of the cases). The CML results, however, are not so satisfactory, with a complete remission rate of 16.6%. Mortality was very high (83.3%) after a two year follow up, versus 14.3% in LCL, which, could be due to the natural course of the disease. In summary, we believe that splenectomy is a therapeutical approach to consider in all those cases with splenic symptoms improving their quality of life.