Five patients with far-advanced Hodgkin’s disease and with evidence of hematopoietic failure were treated by splenectomy in order to determine whether: (1) the course of the disease could be modified, (2) the hematologic picture improved, and (3) responsiveness to nitrogen mustard or x-ray therapy restored. These patients showed a transient slight improvement in their hematologic status, but the course of the disease possibly was accelerated, and the patients all died within thirteen weeks, without showing renewed suitability or increased responsiveness to therapy.
On the basis of our data and a review of thirty cases from the literature, it is concluded that splenectomy is not a useful procedure its Hodgkin’s disease, except for certain specific indications. These may be: (1) an apparently solitary splenic tumor; (2) acquired hemolytic anemia, although this process may be better controlled in some cases by treating the underlying Hodgkin’s disease with x-rays, nitrogen mustard, or triethylene melamine ; (3) thrombocytopenic purpura, which appears to be more profound than is to be expected from the severity and extent of Hodgkin’s disease; and (4) hypersplenism. Hematopoietic depression in the vast majority of patients with Hodgkin’s disease, however, cannot be attributed to splenic overactivity or malfunction.