Abstract
The reticuloendothelial (RE) phagocytic function of the spleen is a major mechanism of defense against invasive infections due to S. pneumoniae and H. influenzae, two organisms which often affect children with cancer. Little information is available about the effects of malignancy and of cytotoxic agents on phagocytic function. Therefore, we studied splenic RE function in children with cancer receiving diverse forms of chemotherapy by quantitation of pitted or pocked erythrocytes (pit counts). The pit count (PC) is the percentage of erythrocytes containing one or more membrane-bound vesicles as determined by interference phase microscopy. The mean PC in 77 normal children and adults was 0.53% (range 0-2.0%), with only 2.6% of normal subjects having values over 1.5%. Mean PC in 28 splenectomized subjects was 37% (range 3.2-81%). Among 158 children with cancer (361 specimens), the mean PC was 1.10% (range 0-12.6%). Forty-six patients (30%) had one or more values above 1.5%, and 16 children (11%) had PC measurements above 3.0%, a level previously suggested to have clinical significance. Elevated PC (> 1.5%) occurred in over 1/3 of children with Wilms' tumor and ALL and appeared to be related to chemotherapy rather than to the malignancy itself. Mild splenic RE hypofunction occurs in many children with cancer, probably results from chemotherapy, and may contribute to the risk of serious infection during treatment with cytotoxic agents.
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Buchanan, G., Holtcamp, C. IMPAIRED SPLENIC RETICULOENDOTHELIAL FUNCTION IN CHILDREN WITH CANCER. Pediatr Res 18 (Suppl 4), 236 (1984). https://doi.org/10.1203/00006450-198404001-00861
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DOI: https://doi.org/10.1203/00006450-198404001-00861
