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Ann Intern Med. 1992 Jun 15;116(12 Pt 1):977-81.

Splenic radiation for corticosteroid-resistant immune thrombocytopenia.

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  • 1Department of Medicine, McMaster University Medical Centre, Hamilton, Ontario, Canada.

Abstract

OBJECTIVE:

To determine the role of splenic radiation as a treatment for immune thrombocytopenia.

DESIGN:

Retrospective analysis of an open, nonrandomized investigation.

SETTING:

A regional cancer center, referred care, and primary care settings.

PATIENTS:

Eleven older patients with idiopathic thrombocytopenic purpura (ITP) and 8 patients with secondary immune thrombocytopenia refractory to corticosteroid treatment for whom surgery would have posed a high risk.

INTERVENTION:

A short course (1 to 6 weeks) of radiation therapy to the spleen (total dose, 75 to 1370 cGy) with or without concurrent and postradiation corticosteroid administration.

MEASUREMENTS:

Efficacy was assessed by measuring any increase in the platelet count and by monitoring the duration of response and side effects.

RESULTS:

Of 11 patients with ITP, 8 patients responded. Three patients had a sustained (greater than 52 weeks) increase in the platelet count to safe levels after therapy was discontinued. An additional patient had a sustained response but required intermittent, low-dose corticosteroids. Four other patients had increases in their platelet counts that lasted from 8 to 25 weeks. Two of the eight patients without ITP had a positive response, whereas four did not respond, and two were not evaluable. Patients had no adverse reactions to the radiation treatment.

CONCLUSION:

Splenic radiation can be a safe and effective method to raise the platelet count in older patients with ITP that is refractory to corticosteroids and in whom the risks associated with splenectomy are high.

PMID:
1586107
[PubMed - indexed for MEDLINE]
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