Nitrogen-mustard therapy combined with splenectomy

Splenectomy for hypersplenism in malignant lymphomas

Splenectomy has been performed in advanced malignant lymphomas in an effect to correct haematological cytopaenias in 41 patients since 1975. In both Hodgkin's disease and a variety of non-Hodgkin's lymphomas the operation has been associated with a high percentage of haematological correction (90 per cent overall). In many of these patients the haematological defect had prevented or led to the cessation of treatment and in those cases where chemotherapy was resumed after splenectomy worthwhile remission was achieved in 87.5 per cent of patients. There was no postoperative deaths and morbidity was considered acceptably low. We conclude that splenectomy is a valuable adjunct to treatment in advanced malignant lymphomas and should be considered at the first suggestion of splenic overactivity and reduced bone marrow reserves.

Effects of nitrogen mustard and splenectomy on mouse bone marrow colony formation in vitro

Improved tolerance of splenectomized patients with Hodgkin's disease (HD) to radiotherapy and chemotherapy has been reported. The present study was undertaken to determine the effects of splenectomy and nitrogen mustard (NM) on colony-forming cells (CFC's) of bone marrow cells obtained from CF1 male mice by in bitro agar-gel technique. Splenectomized mice were given NM intraperitoneally on day 11. On day 15, they were sacrificed and the bone marrow was cultured with a source of colony-stimulating factor (CSF). Spleen extract was prepared by grinding spleens from CF1 mice. On the eighth day of incubation, significantly higher numbers of CFC's were found in splenectomized animals at 1% confidence level (F Test) compared with the nonsplenectomized animals. Both splenectomized and non-splenectomized mice had a greater colony response after NM (at 5% confidence level) than saline-treated controls. Maximum numbers of colonies were obtained in the nustard-treated asplenic animals. Splenic extract, as well as extracts from other organs, when added to the culture plates resulted in inhibition of colony formation. The significance of in vitro inhibition after addition of organ extract is uncertain.