Safely and efficacy of splenic irradiation in the treatment of patients with idiopathic myelofibrosis: a report on 15 patients

Splenic irradiation in idiopathic myelofibrosis (IMF) has often been used i n selected situations when other therapies were unefficient or contraindica ted. This could improve quality of life of patients, but literature remains rare in this field. We have assessed the impact of splenic irradiation in 15 patients with IMF. All of them were no longer responsive to usual treatm ents, and they presented at toast one of the following features: constituti onal symptoms, splenic pain, large splenic size, anemia requiring > 2 units of red blood cell transfusion per month. The planned schedule of radiother apy consisted in daily fractions of 0.4-1 Gy. The median dose of radiothera py per treatment was 9.8 Gy (range, 0.6-30.5). The overall response rate wa s 59% with a median duration of 10 months(range, 1-19). Splenic irradiation was more effective on constitutional symptoms, splenic pain, and spleen si ze. The best responses were noted when full doses of radiotherapy could be delivered, and when patients were previously feewly transfused. Splenic irr adiation effectively palliates IMF-related symptoms, and constitute an alte rnative therapy for patients refractory to usual treatments. (C) 2000 Elsev ier Science Ltd. All rights reserved.