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A retrospective analysis of the long-term effect of splenectomy on late infections, graft-versus-host disease, relapse, and survival after allogeneic marrow transplantation for chronic myelogenous leukemia.

Publication ,  Journal Article
Kalhs, P; Schwarzinger, I; Anderson, G; Mori, M; Clift, RA; Storb, R; Buckner, CD; Appelbaum, FR; Hansen, JA; Sullivan, KM
Published in: Blood
September 1, 1995

The present study was performed as a retrospective analysis of the role of pretransplant splenectomy to determine the incidence of late bacterial infections, acute and chronic graft-versus-host disease (GVHD), relapse, and survival among 358 patients receiving HLA-identical marrow grafts for chronic myelogenous leukemia. Sixty-eight (19%) of the 358 patients had undergone splenectomy before transplantation. There was a trend towards more grade II-IV acute GVHD among splenectomized patients, but this was not significant in the multivariate analysis. The incidence of chronic GVHD was similar for splenectomized and nonsplenectomized patients. Late infectious complications did not significantly differ between splenectomized and control patients (rates per patient year were 0.16 and 0.14, respectively). The overall risk of leukemic relapse was significantly increased for splenectomized patients (56% v 32% for controls, P = .001) and control patients with splenomegaly (P < .0001). Splenectomy and splenomegaly remained significant and independent hazards for relapse in the multivariate analysis (hazard ratio [HR], 1.82, P = .029; and HR, 1.49, P = .002; respectively). Relapse was also increased in patients with advanced disease (HR, 2.95; P = .0001), in patients with T-cell-depleted marrow (HR, 4.51; P = .0001), and in the female donor and male recipient combination (HR, 1.74; P = .044). Patients with splenectomy had an increased overall mortality (HR, 1.18), but this was not statistically significant in the multivariate analysis. In summary, our study showed no significant influence of splenectomy on late posttransplant infections, acute or chronic GVHD, or overall survival. There was no evidence that splenectomy decreased recurrence of chronic myelogenous leukemia.

Duke Scholars

Published In

Blood

ISSN

0006-4971

Publication Date

September 1, 1995

Volume

86

Issue

5

Start / End Page

2028 / 2032

Location

United States

Related Subject Headings

  • Survival Rate
  • Splenomegaly
  • Splenic Diseases
  • Splenectomy
  • Sex Characteristics
  • Retrospective Studies
  • Recurrence
  • Probability
  • Postoperative Complications
  • Mycoses
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kalhs, P., I. Schwarzinger, G. Anderson, M. Mori, R. A. Clift, R. Storb, C. D. Buckner, F. R. Appelbaum, J. A. Hansen, and K. M. Sullivan. “A retrospective analysis of the long-term effect of splenectomy on late infections, graft-versus-host disease, relapse, and survival after allogeneic marrow transplantation for chronic myelogenous leukemia.Blood 86, no. 5 (September 1, 1995): 2028–32.
Kalhs P, Schwarzinger I, Anderson G, Mori M, Clift RA, Storb R, Buckner CD, Appelbaum FR, Hansen JA, Sullivan KM. A retrospective analysis of the long-term effect of splenectomy on late infections, graft-versus-host disease, relapse, and survival after allogeneic marrow transplantation for chronic myelogenous leukemia. Blood. 1995 Sep 1;86(5):2028–2032.

Published In

Blood

ISSN

0006-4971

Publication Date

September 1, 1995

Volume

86

Issue

5

Start / End Page

2028 / 2032

Location

United States

Related Subject Headings

  • Survival Rate
  • Splenomegaly
  • Splenic Diseases
  • Splenectomy
  • Sex Characteristics
  • Retrospective Studies
  • Recurrence
  • Probability
  • Postoperative Complications
  • Mycoses