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Splenic irradiation in chronic lymphocytic leukemia
T Chisesi1, G Capnist, S Dal Fior
1Department of Hematology, S. Bortolo Hospital, Vicenza, Italy.
European Journal of Haematology
|April 1, 1991
Summary
Low-dose splenic irradiation (SI) effectively treated chronic lymphocytic leukemia (CLL) patients with splenomegaly. However, limited response duration after a second SI course suggests combining it with other therapies.
Area of Science:
- Hematology
- Oncology
- Radiotherapy
Background:
- Chronic lymphocytic leukemia (CLL) often presents with splenomegaly.
- Splenic irradiation (SI) has been explored as a treatment modality for CLL.
Purpose of the Study:
- To evaluate the efficacy and duration of remission in CLL patients with splenomegaly treated with low-dose SI.
- To assess the outcomes of a second course of SI upon relapse.
Main Methods:
- 52 patients with stage II-IV CLL and splenomegaly received low-dose SI (1 Gy weekly, total 1-10 doses, median 700 cGy).
- Response rates (Complete Hematologic Remission - CHR, Partial Remission - PR, No Response - NR) and remission durations were recorded.
- 14 patients who relapsed received a second SI course.
Main Results:
- CHR was achieved in 44%, PR in 38%, and NR in 17% after the first SI course.
- Median remission duration was 9 months (CHR: 15 months, PR: 7 months).
- A second SI course yielded lower response rates (2/14 CHR, 9/14 PR) with a median remission duration of 4 months.
Conclusions:
- Low-dose SI is a suitable therapy for CLL patients with significant splenomegaly.
- The limited efficacy and short remission duration after a second SI course indicate a need for combination therapy.
- Consideration should be given to combining SI with splenectomy or alternative treatment approaches for sustained disease control.