EFFICACY OF SPLENECTOMY IN DIFFUSE LARGE CELL LYMPHOMA
(Abstract release date: 05/19/16)
EHA Library. Yevstakhevych Y. 06/09/16; 134622; PB1722
Dr. Yuriy Yevstakhevych
Contributions
Contributions
Abstract
Abstract: PB1722
Type: Publication Only
Background
Diffuse large cell lymphomas (DLCL) are often associated with splenomegaly. Large-size spleen causes both abdominal discomfort, cytopenia, regional portal hypertension and a decreased efficacy of chemotherapy. This is why splenectomy is indicated in such cases.
Aims
To retrospectively analyze the efficacy of splenectomy in patients with diffuse large B-cell lymphoma (DLBCL) and diffuse large Т-cell lymphoma (DLТCL).Methods: 43 patients with DLBCL and two patients with DLТCL underwent splenectomy.
Methods
43 patients with DLBCL and two patients with DLТCL underwent splenectomy.
Results
Splenectomy was performed in 25 male and 18 female patients aged 25-76 years with DLBCL. Indications for splenectomy included splenomegaly (in all patients), hyperslenism (anemia, leukopenia, thrombocytopenia) – in 25 patients (58.1%), regional portal hypertension – in 20 (46.5%) patients; inefficacy of chemotherapy – in 18 (41.9%) patients, and concomitant autoimmune hemolytic anemia (warm type) – in two patients.Splenectomy proved effective in 40 (93%) patients with DLBCL: abdominal syndrome, anemia and leukopenia were reverted, hemolysis in AIHA relieved, and the platelet count was normalized in patients with concomitant thrombocytopenia. The following complications were observed postoperatively: bilateral pneumonia (1 patient), chronic adrenal insufficiency (3 patients), acute thrombophlebitis of superficial veins of the right leg (1 patient), acute pancreatitis (4 patients), and thrombosis of residual limb of the splenic vein (3 patients). One patient died immediately following splenectomy. This lethal outcome was caused by acute cardiovascular insufficiency, which developed within 4 days after operation. Splenectomy did not prove effective in patients with DLBCL. The surgery did not result in normalization of concomitant cytopenia in one female patient who died within 1 month after splenectomy due to both progression of illness and chronic adrenal insufficiency. Another female patient achieved a short-term recovery following surgery (hemoglobin level as well as leukocyte and platelet count normalized) but she developed a cytopenia after 30 days and passed away due to a rapid deterioration of illness and multi-organ insufficiency.As shown by a retrospective analysis of long-term results of splenectomy in patients with DLBCL, the overall survival post splenectomy reached 63.9 months, and the mean treatment-free survival reached 36.8 months. 11 patients did not require administration of chemotherapy following splenectomy at all. 17 patients with DLBCL (39.5 %) developed a relapse of illness at different timepoints after surgery.Splenectomy was performed in two patients with DLТCL. In both cases, surgical treatment proved ineffective, and the patients died within 1 month following intervention due to a relapse of cytopenia, rapid deterioration of illness and multi-organ insufficiency
Conclusion
Splenectomy remains to be an effective treatment option in non-Hodgkin lymphomas. In DLBCL, the surgery helps relieve both abdominal discomfort and hypersplenism; symptoms of regional portal hypertension alleviate; there is less or no need in administration of chemotherapy; and there is no more hemolysis in concomitant AIHA. In DLТCL, splenectomy is ineffective and should be thus avoided.
Session topic: E-poster
Keyword(s): Non-Hodgkin's lymphoma, Splenectomy
Type: Publication Only
Background
Diffuse large cell lymphomas (DLCL) are often associated with splenomegaly. Large-size spleen causes both abdominal discomfort, cytopenia, regional portal hypertension and a decreased efficacy of chemotherapy. This is why splenectomy is indicated in such cases.
Aims
To retrospectively analyze the efficacy of splenectomy in patients with diffuse large B-cell lymphoma (DLBCL) and diffuse large Т-cell lymphoma (DLТCL).Methods: 43 patients with DLBCL and two patients with DLТCL underwent splenectomy.
Methods
43 patients with DLBCL and two patients with DLТCL underwent splenectomy.
Results
Splenectomy was performed in 25 male and 18 female patients aged 25-76 years with DLBCL. Indications for splenectomy included splenomegaly (in all patients), hyperslenism (anemia, leukopenia, thrombocytopenia) – in 25 patients (58.1%), regional portal hypertension – in 20 (46.5%) patients; inefficacy of chemotherapy – in 18 (41.9%) patients, and concomitant autoimmune hemolytic anemia (warm type) – in two patients.Splenectomy proved effective in 40 (93%) patients with DLBCL: abdominal syndrome, anemia and leukopenia were reverted, hemolysis in AIHA relieved, and the platelet count was normalized in patients with concomitant thrombocytopenia. The following complications were observed postoperatively: bilateral pneumonia (1 patient), chronic adrenal insufficiency (3 patients), acute thrombophlebitis of superficial veins of the right leg (1 patient), acute pancreatitis (4 patients), and thrombosis of residual limb of the splenic vein (3 patients). One patient died immediately following splenectomy. This lethal outcome was caused by acute cardiovascular insufficiency, which developed within 4 days after operation. Splenectomy did not prove effective in patients with DLBCL. The surgery did not result in normalization of concomitant cytopenia in one female patient who died within 1 month after splenectomy due to both progression of illness and chronic adrenal insufficiency. Another female patient achieved a short-term recovery following surgery (hemoglobin level as well as leukocyte and platelet count normalized) but she developed a cytopenia after 30 days and passed away due to a rapid deterioration of illness and multi-organ insufficiency.As shown by a retrospective analysis of long-term results of splenectomy in patients with DLBCL, the overall survival post splenectomy reached 63.9 months, and the mean treatment-free survival reached 36.8 months. 11 patients did not require administration of chemotherapy following splenectomy at all. 17 patients with DLBCL (39.5 %) developed a relapse of illness at different timepoints after surgery.Splenectomy was performed in two patients with DLТCL. In both cases, surgical treatment proved ineffective, and the patients died within 1 month following intervention due to a relapse of cytopenia, rapid deterioration of illness and multi-organ insufficiency
Conclusion
Splenectomy remains to be an effective treatment option in non-Hodgkin lymphomas. In DLBCL, the surgery helps relieve both abdominal discomfort and hypersplenism; symptoms of regional portal hypertension alleviate; there is less or no need in administration of chemotherapy; and there is no more hemolysis in concomitant AIHA. In DLТCL, splenectomy is ineffective and should be thus avoided.
Session topic: E-poster
Keyword(s): Non-Hodgkin's lymphoma, Splenectomy
Abstract: PB1722
Type: Publication Only
Background
Diffuse large cell lymphomas (DLCL) are often associated with splenomegaly. Large-size spleen causes both abdominal discomfort, cytopenia, regional portal hypertension and a decreased efficacy of chemotherapy. This is why splenectomy is indicated in such cases.
Aims
To retrospectively analyze the efficacy of splenectomy in patients with diffuse large B-cell lymphoma (DLBCL) and diffuse large Т-cell lymphoma (DLТCL).Methods: 43 patients with DLBCL and two patients with DLТCL underwent splenectomy.
Methods
43 patients with DLBCL and two patients with DLТCL underwent splenectomy.
Results
Splenectomy was performed in 25 male and 18 female patients aged 25-76 years with DLBCL. Indications for splenectomy included splenomegaly (in all patients), hyperslenism (anemia, leukopenia, thrombocytopenia) – in 25 patients (58.1%), regional portal hypertension – in 20 (46.5%) patients; inefficacy of chemotherapy – in 18 (41.9%) patients, and concomitant autoimmune hemolytic anemia (warm type) – in two patients.Splenectomy proved effective in 40 (93%) patients with DLBCL: abdominal syndrome, anemia and leukopenia were reverted, hemolysis in AIHA relieved, and the platelet count was normalized in patients with concomitant thrombocytopenia. The following complications were observed postoperatively: bilateral pneumonia (1 patient), chronic adrenal insufficiency (3 patients), acute thrombophlebitis of superficial veins of the right leg (1 patient), acute pancreatitis (4 patients), and thrombosis of residual limb of the splenic vein (3 patients). One patient died immediately following splenectomy. This lethal outcome was caused by acute cardiovascular insufficiency, which developed within 4 days after operation. Splenectomy did not prove effective in patients with DLBCL. The surgery did not result in normalization of concomitant cytopenia in one female patient who died within 1 month after splenectomy due to both progression of illness and chronic adrenal insufficiency. Another female patient achieved a short-term recovery following surgery (hemoglobin level as well as leukocyte and platelet count normalized) but she developed a cytopenia after 30 days and passed away due to a rapid deterioration of illness and multi-organ insufficiency.As shown by a retrospective analysis of long-term results of splenectomy in patients with DLBCL, the overall survival post splenectomy reached 63.9 months, and the mean treatment-free survival reached 36.8 months. 11 patients did not require administration of chemotherapy following splenectomy at all. 17 patients with DLBCL (39.5 %) developed a relapse of illness at different timepoints after surgery.Splenectomy was performed in two patients with DLТCL. In both cases, surgical treatment proved ineffective, and the patients died within 1 month following intervention due to a relapse of cytopenia, rapid deterioration of illness and multi-organ insufficiency
Conclusion
Splenectomy remains to be an effective treatment option in non-Hodgkin lymphomas. In DLBCL, the surgery helps relieve both abdominal discomfort and hypersplenism; symptoms of regional portal hypertension alleviate; there is less or no need in administration of chemotherapy; and there is no more hemolysis in concomitant AIHA. In DLТCL, splenectomy is ineffective and should be thus avoided.
Session topic: E-poster
Keyword(s): Non-Hodgkin's lymphoma, Splenectomy
Type: Publication Only
Background
Diffuse large cell lymphomas (DLCL) are often associated with splenomegaly. Large-size spleen causes both abdominal discomfort, cytopenia, regional portal hypertension and a decreased efficacy of chemotherapy. This is why splenectomy is indicated in such cases.
Aims
To retrospectively analyze the efficacy of splenectomy in patients with diffuse large B-cell lymphoma (DLBCL) and diffuse large Т-cell lymphoma (DLТCL).Methods: 43 patients with DLBCL and two patients with DLТCL underwent splenectomy.
Methods
43 patients with DLBCL and two patients with DLТCL underwent splenectomy.
Results
Splenectomy was performed in 25 male and 18 female patients aged 25-76 years with DLBCL. Indications for splenectomy included splenomegaly (in all patients), hyperslenism (anemia, leukopenia, thrombocytopenia) – in 25 patients (58.1%), regional portal hypertension – in 20 (46.5%) patients; inefficacy of chemotherapy – in 18 (41.9%) patients, and concomitant autoimmune hemolytic anemia (warm type) – in two patients.Splenectomy proved effective in 40 (93%) patients with DLBCL: abdominal syndrome, anemia and leukopenia were reverted, hemolysis in AIHA relieved, and the platelet count was normalized in patients with concomitant thrombocytopenia. The following complications were observed postoperatively: bilateral pneumonia (1 patient), chronic adrenal insufficiency (3 patients), acute thrombophlebitis of superficial veins of the right leg (1 patient), acute pancreatitis (4 patients), and thrombosis of residual limb of the splenic vein (3 patients). One patient died immediately following splenectomy. This lethal outcome was caused by acute cardiovascular insufficiency, which developed within 4 days after operation. Splenectomy did not prove effective in patients with DLBCL. The surgery did not result in normalization of concomitant cytopenia in one female patient who died within 1 month after splenectomy due to both progression of illness and chronic adrenal insufficiency. Another female patient achieved a short-term recovery following surgery (hemoglobin level as well as leukocyte and platelet count normalized) but she developed a cytopenia after 30 days and passed away due to a rapid deterioration of illness and multi-organ insufficiency.As shown by a retrospective analysis of long-term results of splenectomy in patients with DLBCL, the overall survival post splenectomy reached 63.9 months, and the mean treatment-free survival reached 36.8 months. 11 patients did not require administration of chemotherapy following splenectomy at all. 17 patients with DLBCL (39.5 %) developed a relapse of illness at different timepoints after surgery.Splenectomy was performed in two patients with DLТCL. In both cases, surgical treatment proved ineffective, and the patients died within 1 month following intervention due to a relapse of cytopenia, rapid deterioration of illness and multi-organ insufficiency
Conclusion
Splenectomy remains to be an effective treatment option in non-Hodgkin lymphomas. In DLBCL, the surgery helps relieve both abdominal discomfort and hypersplenism; symptoms of regional portal hypertension alleviate; there is less or no need in administration of chemotherapy; and there is no more hemolysis in concomitant AIHA. In DLТCL, splenectomy is ineffective and should be thus avoided.
Session topic: E-poster
Keyword(s): Non-Hodgkin's lymphoma, Splenectomy
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