Effective management of accelerated phase myelofibrosis with low-dose splenic radiotherapy

A. Pardanani, P. Brown, M. Neben-Wittich, R. Tobin, Ayalew Tefferi

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

The main cause of hepatosplenomegaly in primary (PMF), post polycythemia vera (post-PV MF), and post essential thrombocythemia (post-ET MF) myelofibrosis (MF) is extramedullary hematopoiesis (EMH). Drug-refractory symptomatic splenomegaly in MF is usually managed by splenectomy or involved-field radiotherapy. The latter is most effective in the treatment of MF-associated bone pain and pulmonary hypertension. Our previous experience with hepatosplenic radiotherapy in MF showed efficacy in the majority of treated patients but its utility was limited by the transient nature of its benefit and the occurrence of treatment-related pancytopenia. In an effort to address these issues, we have adopted an induction-maintenance treatment strategy that utilizes lower radiation doses-induction with 100 cGy total in four daily doses of 25 cGy and maintenance with either the same or lower intensity regimen. Herein, we report our most recent experience using this treatment plan in two cases, who in addition to their expected response from the standpoint of splenomegaly, also unexpectedly showed a marked response of their underlying accelerated phase disease, including clearance of circulating blasts and basophilia.

Original languageEnglish (US)
Pages (from-to)715-716
Number of pages2
JournalAmerican journal of hematology
Volume85
Issue number9
DOIs
StatePublished - Sep 2010

    Fingerprint

ASJC Scopus subject areas

  • Hematology

Cite this