Splenic irradiation provides transient palliation for symptomatic splenomegaly associated with primary myelofibrosis: a report on 14 patients
- 366 Downloads
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.
KeywordsMyelofibrosis Splenomegaly Splenic irradiation Palliation
This study was supported by the National Research Group on Idiopathic Bone Marrow Failure Syndromes. The authors would like to express their gratitude to Dr. Keichiro Mihara (Hiroshima University Hospital), Dr. Hideo Tanaka (Hiroshima City Asa Citizens Hospital), Dr. Hironori Take (Toyonaka Municipal Hospital), Dr. Toshie Ogasawara (Tokyo Women’s Medical University Medical Center East), Dr. Yasuhiro Tanaka (Nishi Kobe Medical Center), Dr. Hiroki Yamaguchi (Nippon Medical School Hospital), Dr. Masaya Mukai (Sapporo City General Hospital), Dr. Yuichi Hasegawa (University of Tsukuba Hospital), Dr. Fumi Mizorogi (The Jikei University Daisan Hospital), Dr. Yoshitsugu Kubota (Mitoyo General Hospital), Dr. Tatsuya Adachi (Chukyo Hospital), Dr. Kazuhiko Ikeda (Fukushima Medical University), Dr. Yuka Takada (Kurume University), and Dr. Koh Yamamoto (Yokohama City Minato Red Cross Hospital) for their invaluable contribution to the data.
Compliance with ethical standards
Conflict of interest
The authors declare no conflicts of interest.
- 1.Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon, IARC Press; 2008Google Scholar
- 13.Jaffe ES, Harris NL, Stein H, Vardiman JW. Tumours of haematopoietic and lymphoid tissues. Lyon, IARC Press; 2001Google Scholar
- 15.Passamonti F, Cervantes F, Vannucchi AM, Morra E, Rumi E, Pereira A, et al. A dynamic prognostic model to predict survival in primary myelofibrosis: a study by the IWG-MRT (International Working Group for Myeloproliferative Neoplasms Research and Treatment). Blood. 2010;115(9):1703–8.CrossRefPubMedGoogle Scholar