ABSTRACT
PURPOSE: To determine the effect of low-dose total, or subtotal, nodal irradiation (TNI/sub-TNI) on splenic reticuloendothelial function in pediatric patients with Hodgkin's Disease (HD). PATIENTS AND METHODS: Pediatric and adolescent patients with advanced stage HD were accrued from two Pediatric Oncology Group studies and subdivided into three groups: the first had chemotherapy (CT) only; the second received chemotherapy and low-dose (2,100 cGy) TNI or subtotal TNI (sub-TNI); the third underwent staging laparotomy with splenectomy followed by CT, with or without low-dose radiotherapy. Vesiculated erythrocyte counts (VRBC) were performed on all patients using Nomarski interference phase optics at the conclusion of therapy. RESULTS: The mean VRBCs were 3.2%, and 3.8% for the non-splenectomized patients who received chemotherapy only, and chemotherapy plus low-dose splenic irradiation, respectively. For those who underwent splenectomy before chemotherapy, the VRBC was 36.7%. Statistical analysis revealed no difference in vesiculated erythrocyte percentages between the CT only group and the CT + TNI/sub-TNI patients; however, there was a significant difference between both of these groups and the splenectomized patients. CONCLUSIONS: Our results indicate that the addition of low-dose splenic irradiation to chemotherapy in children and adolescents with advanced-stage Hodgkin's disease does not adversely affect splenic reticuloendothial function.
