Question - Spleen Removal

[rls]

My father is a 59 year old man, has MDS, diagnosed as of last 1 year or so, he has tried many of the more straight forward treatments, and now his Dr. is recommending a spleen removal. Does anyone have any experience(s) they could share with me to pass along to my family and to my father?

Thank you all so much, this is an absolutelty wonderful thing that you are doing just by reading and sharing....

RS

[seniorrico]

Why does your Dr. want to remove your Dad's spleen?

[rls]

blood transfusions are not holding, and they think that remving the spleen will help........apparently some sort of normal practice

[Ruth Cuadra]

Spleen removal usually comes up when the patient has low platelet counts that aren't improved by transfusions or when the spleen is enlarged, which it can be in some cases of MDS, leukemia, and lymphoma. Removing the spleen, in and of itself, is not likely to fully restore the blood counts of an MDS patient because it is the basic blood-producing marrow cells that are damaged. However, it might help the cells that are produced last longer.

According to the AA&MDSIF:

In some subtypes of myelodysplastic syndromes (MDS), such as chronic myelomonocytic leukemia (CMML), the spleen can become very large. When it reaches 20 to 25 cm in length, it can cause reductions in peripheral blood counts. At that point, low dose radiation and/or removal of the spleen may be indicated, especially if it has become large enough to cause vascular problems.

The actual surgery may be done abdominally or laproscopically. If your Dad is a candidate for it, laproscopic surgery is much less invasive and easier to recover from.

I would question the doctors about the specific benefits they would expect for your Dad if he has the surgery and whether radiation to reduce the size of the spleen might help.

Regards,
Ruth Cuadra

[rls]

Yes, thank you for the reply. The idea of the spleen removal is not to "cure" for lack of a better word, the bad blood produced

the idea is that he is getting regualr blood transfusions and they are only lasting a few days, so the dr's want to pro long the time in between transfusions.

He is only a candidate for surgery of the spleen, so my family is very nervous. Do you know of anyone that has had their spleen removed? Anyone have any positive stories to share about this?

[Wayne O'Shana]

Hi rls:

"Splenectomy for the cytopenia associated with MDS is dangerous and frought with complications and is not recommended." See www.emedicine.com/med/topic2695.htm Usually the spleen is enlarged and ready to burst, or pushing against vascular areas or other organs, before such an operation is considered.

On the old listserv I would post a regular rant about demanding leukocyte reduced (filtered) and irradiated blood products for tx to prevent a build-up of antigens that would cause tx failure. If you go on Google and type irradiation leukocyte reduction blood you will see 260,000 hits. Some of the older stuff is out of date...try www.aaaoi.org and cick FAQ for something written for normal people.

[Albert Seufert]

ris:

I had my spleen removed in 2002. Don't know if it made any difference. I was dx MDS and pancreatic cancer. They removed the spleen when they operated on the pancreas. I did not need transfusions at that time. The MDS continued to progress and transfusions were started in 2004. Time between transfusions has shortened and are now 2 weeks apart. There are risks associated with all operations and I would be more concerned with them than with the loss of the spleen.

[rls]

Albert - When were you diagnosed wtih MDS?

[Albert Seufert]

rls: Diagnosed MDS along with pancreatic cancer in Nov 2002. Spleen was conviently removed during pancreatic operation. My MDS invovles all three lines as well as abnormal karyotype.