Splenic irradiation for chronic autoimmune thrombocytopenic purpura in patients with contra-indications to splenectomy.
We treated by splenic irradiation eight patients with chronic idiopathic thrombocytopenic purpura (ITP, seven cases) or secondary autoimmune thrombocytopenic purpura (one case) who had contra-indications to splenectomy. A total dose of 15 Gy was delivered to the spleen, with left kidney protection. One patient had a good durable response (> 1 year); two patients had a good transient response (of 3 months duration) but they responded again to a second course of irradiation; two patients had only partial response, but have required no other treatments for 2 years; the three remaining patients had no response. Side-effects were minor. Therefore splenic irradiation appears to be a therapeutic option in patients with chronic ITP who have contra-indications to splenectomy.
Caulier
M T
MT
Service des Maladies du Sang, C.H.U. Lille, France.
Darloy
F
F
Rose
C
C
Camier
G
G
Morel
P
P
Bauters
F
F
Fenaux
P
P
D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000532:radiotherapy*; D002908:Chronic Disease; D000075202:Contraindications; D006801:Humans; D011446:Prospective Studies; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000532:radiotherapy*; D013154:Spleen / Q000528:radiation effects*; D013156:Splenectomy; D016896:Treatment Outcome