A 33-year-old man was admitted because of abdominal distension on May 23, 1975. A diagnosis of chronic myelocytic leukemia (CML) was made because of leukocytosis, splenomegaly, Piladelphia chromosome (Ph1) positive and a low score of neutrophil alkaline phosphatase activity (NAP). The splenectomy was performed on the chronic phase after 2 years 4 months from the diagnosis in order to prevent the devolopment of acute crisis in a spleen. In this case, no agent has been administered after the splenectomy except a small amount of vercyte immediately after the operation. Lymphoadenopathy, disseminated intravascular coagulation (DIC) and leukemic meningitis were developed at the final course. The variation of leukocyte and platelet count were observed, and the leukocyte count increased to 228×103/cmm and then showed a plateau before the acute crisis. Cell infiltration was recognized rather the generalized lymphnodes than the liver by the pathological findings, and cell kinetics after a splenectomy of CML was discussed. A new protocol of chemotherapy after the splenectomy of CML to induce a more prolonged survival will be expected, and then an effect of the splenectomy should be discussed.
