Effect of prior splenectomy on hematologic tolerance during total lymphoid radiotherapy of patients with Hodgkin's disease

SPLENEC-T tomy in the clinical staging of untreated patients with Hodgkin's disease has been previously demonstrated.314Such splenectomized patients have seemed to have fewer and less severe episodes of thrombocytopenia, leukopenia, and related complications during their subsequent radiation therapy.That clinical impression is analyzed in this retrospective examination of the hematologic responses to total lymphoid radiation therapy in 50 patients with and 50 patients without prior splenectomy. METHODSThe records of all previously untreated patients with Hodgkin's disease seen in the Division of Radiation Therapy, Stanford University Medical Center between January 1965, and May 1969, were reviewed.Those patients who received megavoltage doses of 4,400 rads to all lymph node areas, as shown in Fig. 1, were selected for study.From these, 50 consecutive patients who underwent pretreatment splenectomy were designated as Group A, and 50 patients who retained their spleens were designated as Group B. Their peripheral platelet and white blood cell counts were recorded prior to.initiation of therapy and 1 to 2 days before and after splenectomy in Group A; twice weekly during radiotherapy; and at follow-up periods of 1, 3, 6, and 12 months after conclusion of therapy.For each of the 100 patients, the lowest platelet and white blood cell values occurring during treatment