DURABLE REMISSION AFTER SPLENECTOMY FOR WALDENSTROMS MACROGLOBULINEMIA WITH MASSIVE SPLENOMEGALY IN LEUKEMIC PHASE

Citation
N. Takemori et al., DURABLE REMISSION AFTER SPLENECTOMY FOR WALDENSTROMS MACROGLOBULINEMIA WITH MASSIVE SPLENOMEGALY IN LEUKEMIC PHASE, Leukemia & lymphoma, 26(3-4), 1997, pp. 387-393
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology
Journal title
ISSN journal
1042-8194
Volume
26
Issue
3-4
Year of publication
1997
Pages
387 - 393
Database
ISI
SICI code
1042-8194(1997)26:3-4<387:DRASFW>2.0.ZU;2-Z
Abstract
A patient with M-proteinemia (IgM, kappa type), lymphocytosis, anemia, and massive splenomegaly, was diagnosed as having Waldenstrom's macro globulinemia (WM). Since this case was refractory to chemotherapy, spl enic irradiation was performed, which effectively reduced the serum Ig M level, spleen size, and lymphocyte counts; however, its effect was t ransient, Splenectomy was then carried out. The spleen contained abund ant IgM-producing lymphocytes, and after splenectomy, the serum IgM va lues decreased and the peripheral blood counts returned to near normal . The transient increases of serum IgM occurred during two infectious episodes postoperatively. The patient has now been in a satisfactory r emission for six years after splenectomy. The removal of an IgM-produc ing/secreting site and release from hypersplenism may be the major mec hanisms involved in achieving the durable remission after splenectomy. In individual cases of WM with massive splenomegaly, we recommend spl enectomy as part of the management of this disorder.