Blood, 1954, Vol. 9, No. 8, pp. 824-836.
© 1954 American Society of Hematology, Inc.
Splenectomy in Far-Advanced Hodgkin’s Disease
Report of Five Cases
MARGUERITE P. SYKES 1,
DAVID A. KARNOFSKY 1,
GORDON P. MCNEER 1, and
LLOYD F. CRAVER 1
1 Chemotherapy, Medical, and Gastric Services, Memorial Hospital, New York,
N. Y.
Five patients with far-advanced Hodgkin’s disease and with evidence of hematopoietic failure were treated by splenectomy in order to determine whether: (1)
the course of the disease could be modified, (2) the hematologic picture improved,
and (3) responsiveness to nitrogen mustard or x-ray therapy restored. These patients showed a transient slight improvement in their hematologic status, but
the course of the disease possibly was accelerated, and the patients all died
within thirteen weeks, without showing renewed suitability or increased responsiveness to therapy.
On the basis of our data and a review of thirty cases from the literature, it is
concluded that splenectomy is not a useful procedure its Hodgkin’s disease, except
for certain specific indications. These may be: (1) an apparently solitary splenic
tumor; (2) acquired hemolytic anemia, although this process may be better controlled in some cases by treating the underlying Hodgkin’s disease with x-rays,
nitrogen mustard, or triethylene melamine ; (3) thrombocytopenic purpura,
which appears to be more profound than is to be expected from the severity and
extent of Hodgkin’s disease; and (4) hypersplenism. Hematopoietic depression
in the vast majority of patients with Hodgkin’s disease, however, cannot be
attributed to splenic overactivity or malfunction.
Submitted on October 23, 1953
Accepted on December 17, 1953
