Functional Hyposplenia After Splenic Irradiation for Hodgkin's Disease

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Abstract
A patient who developed fulminant pneumococcal sepsis 12 yr after successful treatment for Hodgkin''s disease, which included splenic irradiation, was previously reported. Splenic size and function in 25 patients who had received splenic irradiation 5-16 years previously for Hodgkin''s disease (n = 19) or non-Hodgkin''s lymphoma (n = 6) were evaluated. Mean maximum splenic diameter as measured on a 99mTc-sulfur colloid liver-spleen scan was 6.2 cm in the irradiated group and 9.7 cm in a control group (P < 0.001). The mean percentage of erythrocytes containing pits when observed with interference phase microscopy was 13.0% in the irradiated group, which was significantly different (P < 0.001) from the levels found in each of the control groups: normal subjects, 0.9%; unstaged and untreated lymphoma patients, 0.6%; and patients after splenectomy, 33.7%. Patients who have had splenic irradiation should be considered at risk of developing overwhelming pneumococcal sepsis.

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