Fulminant sepsis after the successful treatment of Hodgkin's disease

Of 14 splenectomized patients with Hodgkin's disease who were treated with total nodal irradiation and combination chemotherapy (MOPP), fulminant sepsis developed in three (21.4 per cent) while they were in remission; two died within hours. Similar cases were not observed in a larger group of 146 patients with Hodgkin's disease (including 104 splenectomized patients who were treated less intensely). Our experience indicates the need for caution when asplenic persons are aggressively treated with both radiation and drugs.