Locoregional intrasplenic chemotherapy for hypersplenism in myelofibrosis

A 79-year-old patient with post-polycythaemic myelofibrosis presented with severe hypersplenism. After splenic artery catheterization, cytosine arabin oside was given intrasplenically from November 1999 to March 2000 for 5 d/m onth at 10 mg/m(2) and increased each month by 10 mg/m(2). It was then admi nistered by continuous infusion until June 2000, starting at 20 mg/m(2)/d a nd tapering by 5 mg/m(2) every 2 weeks to a final daily dose of 5 mg/m(2)/d . The drug was then stopped. The spleen had decreased to one third of the i nitial volume. Clinical conditions and haematological indices improved subs tantially. Intrasplenic therapy could be a new therapeutic tool for hypersp lenism in chronic idiopathic and post-myeloproliferative myelofibrosis.