Usefulness of Low-Dose Splenic Irradiation prior to Reduced-Intensity Conditioning Regimen for Hematopoietic Stem Cell Transplantation in Elderly Patients with Myelofibrosis
Joint Authors
Matsubara, Etsuko
Yamanouchi, Jun
Kitazawa, Riko
Azuma, Taichi
Hato, Takaaki
Fujiwara, Hiroshi
Yasukawa, Masaki
Source
Issue
Vol. 2016, Issue 2016 (31 Dec. 2016), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2016-10-20
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
The Janus kinase (JAK) 1 and 2 inhibitor, ruxolitinib, was recently approved in Japan and has been effective in many patients with myelofibrosis (MF).
Although the inhibitor decreases splenomegaly and relieves MF-related symptoms, allogeneic hematopoietic cell transplantation (HCT) remains as the only curative therapy for MF.
The presence of splenomegaly has been reported as a risk factor for graft failure, delayed engraftment, and poor survival.
Here, we report two elderly MF patients with massive splenomegaly and a JAK2 V617F mutation.
These patients underwent splenic irradiation to decrease splenomegaly prior to HCT with a reduced-intensity conditioning (RIC) regimen.
Massive splenomegaly gradually decreased by 4 Gy splenic irradiation.
The subsequent RIC regimen involved 4 Gy total body irradiation and fludarabine and intravenous busulfan.
In both patients, engraftment failure did not occur, and complete remission was achieved.
The splenomegaly decreased, and MF-related symptoms were resolved.
Furthermore, the JAK2 V617F mutation disappeared, and fibrosis in the bone marrow regressed.
We suggest that splenic irradiation prior to the RIC regimen for HCT in elderly MF patients with massive splenomegaly is safe.
Furthermore, the HCT protocols with splenic irradiation should be considered for patients who have not shown clinical benefits to optimal medical management such as treatment with ruxolitinib.
American Psychological Association (APA)
Matsubara, Etsuko& Yamanouchi, Jun& Kitazawa, Riko& Azuma, Taichi& Fujiwara, Hiroshi& Hato, Takaaki…[et al.]. 2016. Usefulness of Low-Dose Splenic Irradiation prior to Reduced-Intensity Conditioning Regimen for Hematopoietic Stem Cell Transplantation in Elderly Patients with Myelofibrosis. Case Reports in Hematology،Vol. 2016, no. 2016, pp.1-6.
https://search.emarefa.net/detail/BIM-1100894
Modern Language Association (MLA)
Matsubara, Etsuko…[et al.]. Usefulness of Low-Dose Splenic Irradiation prior to Reduced-Intensity Conditioning Regimen for Hematopoietic Stem Cell Transplantation in Elderly Patients with Myelofibrosis. Case Reports in Hematology No. 2016 (2016), pp.1-6.
https://search.emarefa.net/detail/BIM-1100894
American Medical Association (AMA)
Matsubara, Etsuko& Yamanouchi, Jun& Kitazawa, Riko& Azuma, Taichi& Fujiwara, Hiroshi& Hato, Takaaki…[et al.]. Usefulness of Low-Dose Splenic Irradiation prior to Reduced-Intensity Conditioning Regimen for Hematopoietic Stem Cell Transplantation in Elderly Patients with Myelofibrosis. Case Reports in Hematology. 2016. Vol. 2016, no. 2016, pp.1-6.
https://search.emarefa.net/detail/BIM-1100894
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1100894