Surgery for Chronic Lymphocytic Leukemia

Surgery has a very limited role in treating chronic lymphocytic leukemia (CLL). Because CLL cells tend to spread widely throughout the bone marrow and to many organs, surgery cannot cure this type of cancer. It's rarely needed even to diagnose CLL, which can often be done with blood tests. Sometimes minor surgery is needed to remove a lymph node to help diagnose or stage the cancer.

Splenectomy

In rare cases, the spleen may be removed (splenectomy). This isn't expected to cure the CLL, but it can help improve some of the symptoms. Sometimes CLL can make the spleen grow so large that it presses on nearby organs and causes problems. If radiation or chemotherapy doesn't 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 the spleen gets too large, it may become too active in removing blood cells, leading to a shortage of red blood cells or platelets. When this happens, taking out the spleen can help improve blood counts. This is done much more often for patients with hairy cell leukemia than for those with regular CLL.

Most people have no problem living without a spleen, but they're at higher risk for certain bacterial infections. Doctors recommend certain vaccines for people before their spleen is removed. If your spleen has been removed, be sure to report any signs of infection to your health care team right away.