Early splenectomy and polychemotherapy versus polychemotherapy alone in chronic myeloid leukemia.

the effect of early splenectomy and of polychemotherapy with hydroxyurea, busulfan, and alternate bimonthly course if arabinosyl cytosine and vincristine plus prednisone, was evaluated in 139 previously untreated patients with chronic myeoid leukemia (CML), consecutively admitted to 18 hospitals from March 1973 to october 1974. Fify-six patients were splenectomized and 83 patients were not splenectomized. Splenectomy did not influence the duration of chronic and blastic phase, and did not prolong survival. The prognosis of high risk splenectomy group, and five patients developed thrombotic or thromboembolitic complications, 5 to 19 months after the operatios. The median survival of whole group was 50 months, with 32 of 139 remaing alive 72 months after diagnosis, but the slope of survival curve was similar to that of historical controls. the results of this trial suggest that new strategies should be developed for the treatment of CML.