Blood counts should be followed every 1 to 2 wk and the dosage adjusted accordingly. Busulfan is no longer recommended. However, because no studies have demonstrated the superiority of these drugs, they are not preferred over hydroxyurea. Although splenic radiation is rarely used, it may be helpful in refractory cases of CML or in terminal patients with marked splenomegaly. Treatment should begin with very low doses and careful evaluation of the WBC count.
Response is usually disappointing.
Splenectomy may alleviate abdominal discomfort, improve thrombocytopenia, and relieve transfusion requirements when splenomegaly cannot be controlled with chemotherapy or irradiation. Remissions and survival tend to be brief. All rights reserved.