Chronic Myeloid Leukemia (CML): Surgery

In rare cases, chronic myeloid leukemia (CML) may be treated with surgery to remove a swollen spleen. This is called a splenectomy. The goal is not to cure CML, but to improve symptoms so you feel better.

The spleen is an organ near the stomach. It's part of the lymphatic system that makes white blood cells and destroys old red blood cells. It also helps to prevent infections by filtering bacteria in the blood.

A splenectomy may help improve blood counts and relieve pressure and mild pain from an enlarged spleen that's pressing on nearby tissues and organs. A splenectomy might be advised if:

• Your spleen is so swollen that it's pushing on other organs, such as your stomach. Other treatments, such as targeted therapy, chemotherapy or radiation therapy, are often tried first to shrink the spleen.
• Your spleen is filtering out too many red blood cells and platelets from your blood. It's your spleen's job to remove worn-out blood cells. But leukemia can make your spleen overactive. A splenectomy can help raise the number of red blood cells and platelets in your blood.

You may need some vaccines before surgery to remove your spleen. This is because your risk for certain infections will go up after your spleen is removed.

A splenectomy is done in a hospital. The surgery takes up to a few hours, depending on how the surgery is done. Splenectomy can be done by making one large cut (incision) or a few smaller incisions in your belly (abdomen). The main artery going to your spleen is tied off. The spleen is removed. Your incision is then closed with stitches (sutures). Talk with your doctor about whether you'll need to stay in the hospital after surgery.

You'll need to be careful to prevent infection after your surgery and for the rest of your life. That's because your spleen helps protect you against some types of infection. Your doctor will likely encourage you to get vaccines to help prevent certain infections. You'll get more information on this.