IMRT/IGRT Helical Tomotherapy: A Successful Treatment of Lung Parenchyma Compression Due to Extramedullary Haematopoiesis in β-Thalassaemia - A Case Report

European Medical Journal Hematology

article

Giorgia De Gregorio¹  Salvatore D’Alessandro¹  Giovanna Trapani¹  Emanuele Quartuccio¹  Antonio Lo Casto³  Giovanna Evangelista² 

[1] Department of Radiation Oncology, University of Palermo;Radiation Oncology Unit, ARNAS Civico Hospital;Radiation Oncology School, Section of Radiological Sciences, DIBIMED, University of Palermo

关键词: Extramedullary;    haematopoiesis;    radiotherapy;    thalassaemia.;   

DOI  :  10.33590/emjhematol/21-00205

来源: European Medical Journal

【 摘 要 】

Thalassaemia is a chronic haemolytic anaemia that is endemic in the Mediterranean Basin. Extramedullary haematopoiesis (EMH) is a natural compensatory reaction involving several organs or tissues. This report outlines a case of dyspnoea due to bilateral dorsal paravertebral EMH, which was treated successfully with helical tomotherapy, a technique that combines intensity-modulate radiation therapy with image-guided radiation therapy. By the end of the first week of treatment, an increase in the haemoglobin value (up to 7.8 g/dL) and a remarkable reduction of dyspnoea were obtained, with haemoglobin values maintained at 7.8–7.3 g/dL without further blood transfusions. At 1-year follow-up, the patient was totally asymptomatic, with a complete resolution of dyspnoea and asthenia. The therapeutic approach to EMH remains controversial because there are no pre-established protocols, with current treatments including serial blood transfusions, hydroxyurea, radiation therapy, and surgical decompression. This clinical case description reports how helical tomotherapy may be used as a valid and effective treatment for compressive atelectasis due to EMH. In fact, radiation therapy improved the general clinical condition and self-reported symptoms of the patient and reduced the size of EMH masses visible in the chest CT scan.

【 授权许可】

CC BY-NC