Surgery for chronic lymphocytic leukemia

Surgery has a very limited role in treating chronic lymphocytic leukemia (CLL). Because CLL cells spread so widely throughout the bone marrow and to many organs, surgery cannot cure this type of cancer. It rarely has any role even in the diagnosis of CLL, which can often be made with a blood sample. Minor surgery is sometimes needed to remove a lymph node to aid in diagnosing or staging the cancer.

Splenectomy

In rare cases, the spleen may be removed (splenectomy). This is not expected to cure the leukemia, but it can help improve some of the symptoms. Sometimes the spleen becomes so large that it presses on nearby organs and causes symptoms. If radiation or chemotherapy does not help shrink the spleen and reduce symptoms, splenectomy may be an option.

Splenectomy may also improve blood cell counts and lower the need for blood product transfusions. One of the spleen's normal functions is to remove worn-out blood cells from the bloodstream. If leukemia or other diseases cause the spleen to become too large, it may become too active in removing blood cells, leading to a shortage of red blood cells or platelets. Taking out the spleen may help prevent this. Splenectomy is used much more often for hairy cell leukemia than for regular CLL.

Most people have no problem living without a spleen. The risk for certain bacterial infections is increased, which is why doctors often recommend certain vaccines for people who have had their spleen removed.