Splenectomy Effects on Chemotherapy in Hodgkin's Disease

Abstract

We examined splenectomy effect on subsequent administration of intensive, intermittent combination chemotherapy in patients with disseminated Hodgkin's disease. Otherwise comparable patients with Hodgkin's disease received more chemotherapeutic agents in a shorter period of time when they had undergone prior splenectomy. Asplenic patients had higher circulating platelet and lymphocyte counts prior to chemotherapy onset, most likely due to removing a splenic pool of these cells. After four courses of chemotherapy there was a proportionately greater fall in the white blood cell and platelet counts in the asplenic group. This indicates that asplenic patients tolerated delivery of greater amounts of drug in shorter periods of time, and this is reflected in their greater degree of myelosuppression. Preliminary data suggest that there may be enhanced response rate in the asplenic group.