İdiyopatik myelofibrozis tanılı olguda adaptif splenik radyoterapi

İdiyopatik myelofibrosis kronik myeloproliferatif bir hastalıktır. Kronik myeloproliferatifhastalıklar myeloid hücre büyümesi ile ilişkili klonal kök hücre bozukluklarıdır. Kemik iliğiyetersizliğine bağlı görülen ekstramedüller hematopoez ve artmış eritropoez sonucu masifsplenomegali gelişir, bu da anemi ve abdominal rahatsızlığa yol açarak morbiditeye sebep olur.Splenik radyoterapi masif splenomegaliye bağlı görülen abdominal ağrı, anemi ve trombositopenigibi semptomları palyasyon amacıyla önerilmektedir. Bu çalışmada idiyopatik myelofibrozis tanısıile takip edilen 59 yaşındaki erkek olgu değerlendirildi. Masif splenomegaliye bağlı narkotikanaljezik kullanımı gerektiren şiddetli ağrı, hipersplenizmin neden olduğu ciddi trombositopeni vetekrarlayan transfüzyon ihtiyacı sonucu palyasyon amacı ile haftada 2 fraksiyon toplamda 6fraksiyon olacak şekilde haftalık artan dozlarda splenik RT uygulandı. Tedavi sonrası olgununabdominal ağrısında %100 palyasyon sağlandığı görüldü. Splenik RT, semptomatiksplenomegalinin palyatif tedavisinde etkin bir tedavi modalitesi olarak göz önündebulundurulmalıdır.

Adaptive splenic radiation in a case of idiopathic myelof ibrosis

Idiopathic myelofibrosis is a chronic myeloproliferative disorder. Chronic myeloprolipherativedisorders are clonal stem cell disorders associated with myeloid cell growth . Extramedullaryhematopoiesis in the bone marrow deficiency and increased erythropoiesis resultin massivesplenomegaly which then lead to anemia and abdominal discomfort which are major causes ofmorbidity in these cases. Splenic radiotherapy is recommended for palliation of symptoms such asabdominal pain, anemia and thrombocytopenia due to massive splenomegaly. In this study, a 59- year-old male patient with a diagnosis of idiopathic myelofibrosis was evaluated. Splenicradiotherapy was applied to him in 2 fractions per week with increasing doses for a total of 6fractions as he had massive splenomegaly, severe pain requiring narcotic analgesic use, and hadrepeated need for transfusion caused by severe thrombocytopenia due to hypersplenism Hisabdominal pain palliation was achieved by 100% after treatment. . Splenic radiotherapy should beconsidered as an effective treatment modality for palliative treatment of symptomaticsplenomegaly.

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