Partial splenic embolization for cancer patients with thrombocytopenia requiring systemic chemotherapy.
BACKGROUND
Partial splenic embolization (PSE) has been used to improve hematologic parameters related to hypersplenism. The purpose of this study was to review our institutional experience with PSE for cancer patients with thrombocytopenia because of splenic sequestration precluding the administration of systemic therapy (ST).


METHODS
A retrospective review of cancer patients undergoing PSE was undertaken. Twenty-eight patients underwent PSE to correct thrombocytopenia to facilitate the initiation or resumption of ST. Primary and secondary endpoints of the current study included a platelet count increase > 150 K/UL and the initiation of ST, respectively. Periprocedural laboratory values and adverse events were recorded.


RESULTS
Thirty PSEs were performed in 28 patients. Two patients underwent repeat PSE because of recurrent thrombocytopenia after the successful initiation of ST. For procedures with adequate follow-up, primary and secondary endpoints were achieved in 96.3% (26 of 27 patients) and 95.7% (22 of 23 patients) of patients, respectively. The mean platelet count was 81 K/UL immediately before PSE and peaked at 293 K/UL after PSE. For 23 patients with frequent laboratory follow-up, the mean time to a platelet count > 150 K/UL was 10 days. The mean hospital stay was 4.5 days. Postprocedure abdominal pain occurred in all patients. Fever was documented in 16 patients and pulmonary consolidation/atelectasis or effusion was documented in 10 patients; 9 patients received empiric antibiotic coverage. The median overall survival was 9.40 months (95% confidence interval, 8.2-10.7 months) among the 28 patients after PSE.


CONCLUSIONS
PSE is a safe and effective means of managing thrombocytopenia secondary to hypersplenism to facilitate the administration of ST in patients with cancer.
Kauffman
Christopher R
CR
Section of Interventional Radiology, Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-4009, USA.
Mahvash
Armeen
A
Kopetz
Scott
S
Wolff
Robert A
RA
Ensor
Joe
J
Wallace
Michael J
MJ
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015331:Cohort Studies; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006971:Hypersplenism / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D013921:Thrombocytopenia / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
D000970:Antineoplastic Agents