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Paraspinal extramedullary hematopoiesis in patients with thalassemia intermedia

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Abstract

Ineffective erythropoiesis in patients with thalassemia intermedia drives extramedullary hematopoietic tumor formation in several parts of the body. Paraspinal involvement has received increasing attention due to the associated morbidity secondary to spinal cord compression. Although the history and physical examination may help narrow the differential diagnosis, radiographic imaging remains essential to confirm the existence of hematopoietic tissue. Characteristic appearance has been observed mainly on magnetic resonance imaging. Several treatment options have been described, including transfusion therapy, laminectomy, radiotherapy, and the use of fetal hemoglobin inducing agents that decrease the hematopoietic drive. However, the ideal management scheme remains controversial. Until large prospective trials evaluate the efficacy and safety of the available treatment options, both in single and in combination therapy, an individualized approach should be entertained.

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The authors have no conflicts of interest to disclose. This study did not receive external funding.

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  1. Division of Orthopedic Surgery, Department of Surgery, American University of Beirut Medical Center, 11-0236, Riad El Solh, Beirut, 1107 2020, Lebanon

    Rachid Haidar

  2. Spine Service, Hospital Universitario de Gran Canaria, Las Palmas, Spain

    Hani Mhaidli

  3. Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon

    Ali T. Taher

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  1. Rachid Haidar
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Haidar, R., Mhaidli, H. & Taher, A.T. Paraspinal extramedullary hematopoiesis in patients with thalassemia intermedia. Eur Spine J 19, 871–878 (2010). https://doi.org/10.1007/s00586-010-1357-2

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