Splenic irradiation provides transient palliation for symptomatic splenomegaly associated with primary myelofibrosis: a report on 14 patients

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• 作者：Akira Kitanaka ; Katsuto Takenaka ; Kotaro Shide…
• 关键词：Myelofibrosis ; Splenomegaly ; Splenic irradiation ; Palliation
• 刊名：International Journal of Hematology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：103
• 期：4
• 页码：423-428
• 全文大小：398 KB
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• 作者单位：Akira Kitanaka (1)
  Katsuto Takenaka (2)
  Kotaro Shide (1)
  Toshihiro Miyamoto (2)
  Tadakazu Kondo (3)
  Keiya Ozawa (4)
  Mineo Kurokawa (5)
  Koichi Akashi (2)
  Kazuya Shimoda (1)
  
  1. Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
  2. Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
  3. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  4. The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
  5. Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  
• 刊物主题：Hematology; Oncology;
• 出版者：Springer Japan
• ISSN：1865-3774

文摘

We retrospectively analyzed the outcomes of 14 patients with primary myelofibrosis who were treated with splenic irradiation (SI) for symptomatic splenomegaly between January 2000 and December 2012 at 12 hospitals. Median age at the time of SI was 67 years (range 47–76). The median dose of radiation per course was 5 Gy, administered in a median of eight fractions. Spleen size was reduced in 93 % of patients, and persisted for a median of 2.2 months (range 0.1–13.8). Symptom relief occurred in 86 % of patients, and lasted for a median of 2.5 months (range 0.1–16.5). Although SI provided a high rate of palliation for patients with symptomatic splenomegaly, the responses were transient. Significant thrombopenia (<25 × 109/L) occurred in eight patients (57 %), and neutropenia (<0.5 × 109/L) was observed in seven (50 %). Nine patients (64 %) required an increased number of red blood cell transfusions after SI. Five patients (36 %) developed serious infections, with two deaths (14 %), as a result of SI-induced cytopenia. The median survival for all patients after SI was 18.5 months (range 0.1–71.9). The Dynamic International Prognostic Scoring System model effectively distinguished the prognosis after SI between patients in the intermediate-2 and high-risk groups.