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The Role of the Spleen in the Hemolytic Anemia of Cancer Patients^*

( Department of Medicine, Columbia University College of Physicians and Surgeons and the Medical Services, Francis Delafield and Presbyterian Hospitals, New York, N.Y.)

It has been demonstrated that hemolysis contributes significantly to the anemia of malignancy. The present study was undertaken to determine the role of the spleen in this hemolytic process.

Following injection of Cr⁵¹-labeled erythrocytes, the change in radioactivity, with time, above the heart, spleen, and liver was determined by using a body-surface counting technic.

In subjects with normal red cell survival, the ratios of spleen/heart (Sp/H) and of liver/heart (L/H) counts at zero time are less than one, and neither ratio increases significantly above one with time.

In a patient with congenital spherocytic anemia and in a patient with idiopathic Coombs-positive hemolytic anemia, maximal Sp/H ratios were significantly greater than simultaneous L/H ratios, confirming the findings reported in the literature.

In most patients with malignant tumors and shortened red cell survival, but negative Coombs tests, there was also found a moderate to marked increase of radioactivity over the spleen. It is concluded that, in the hemolytic anemia of many patients with malignant tumors, the spleen plays an active role in the removal of red blood cells.

^* Presented in part at the annual meeting of the American Association for Cancer Research, Philadelphia, Pennsylvania, April 11, 1958.

This work was supported in part by a grant (C 2332) from the National Cancer Institute of the National Institutes of Health, United States Public Health Service.

Received 5/ 5/58.