David C. Calverley, MD; Glenn W. Jones, MD; John G. Kelton, MD
▪ 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 (> 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.
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Calverley DC, Jones GW, Kelton JG. Splenic Radiation for Corticosteroid-resistant Immune Thrombocytopenia. Ann Intern Med. 1992;116:977–981. doi: 10.7326/0003-4819-116-12-977
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Published: Ann Intern Med. 1992;116(12_Part_1):977-981.
Coagulopathies, Hematology/Oncology, Platelet Disorders.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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