The mechanism of action of splenic irradiation in chronic myelogenous leukemia.

The mechanism of action of splenic irradiation in the induction of a remission in chronic myelogenous leukemia was investigated in six patients using a leukocyte kinetic approach. The leukocytes were labelled in vitro with radioactive diisopropylfluorophosphate-32 and returned to the circulation. The effect of treatment on the rate of change of leukocyte specific activity was determined. The results suggest (1) that irradiation of the spleen damages granulopoietic cells as they cycle back and forth between the spleen, blood and other extravascular compartments; (2) that damage to exchangeable granulopoietic cells in transit through the irradiated spleen may explain the long remission often encountered after this form of therapy.