A 58 year-old female was admitted to the hospital because of failure to chemotherapy of chronic lymphocytic leukemia (CLL).
Anemia, huge spleen and splenic pain were noted on phyical examination. Hemoglobin was 9.0 gr/dl, white cell count 83,700/μl with 91% CLL cells and platelet count 13.1×104/μl. Bone marrow aspiration showed hypercellular bone marrow with 79.6% CLL cells. The surface marker analysis was positive for IgG-λ, Ia and Bl. CLL cell kinetic study with Indium-111 method showed that CLL cells remarkably accumulated in the spleen and the splenic transit time was 80 hours. Because of rapid improvement of physical finding, splenic irradiation (SI) was given with liniac. First SI was given total 6 Gray and second SI 12 Gray. Disease-related symptoms rapidly disappeared and hematological improvement was obtained. Duration of response to first SI and second SI were 1 and 2 years, respectively.
The posible mechanism of effectiveness of SI were discussed together with results of CLL cell kinetic study.
