Document Detail


Helical tomotherapy for extramedullary hematopoiesis involving the pericardium in a patient with chronic myeloid leukemia.
MedLine Citation:
PMID:  20661700     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Extramedullary hematopoiesis (EMH) refers to the development of foci of hematopoiesis outside its normal location in the bone marrow. This occurs normally during fetal development but is abnormal postpartum. The most common sites of EMH are the spleen and liver. The phenomenon occurs in a number of disease states, notably in myelofibrosis, thalassemia, immune thrombocytopenic purpura, sickle cell anemia, polycythemia vera, and myelodysplastic syndrome. Affected patients often develop symptoms related to the location of the EMH. Reported treatments include red blood cell transfusions, surgical excision, decompressive laminectomy in cases of cord compression, chemotherapy, and irradiation. Radiation therapy is highly effective for treating hematopoietic tissue because such tissues are extremely radiosensitive. Megavoltage helical tomotherapy is a technical advance in the delivery of radiation therapy, allowing more conformal and precise treatments. The present case report describes a patient with the diagnosis of atypical chronic myeloid leukemia and myelofibrosis who subsequently developed EMH of the pericardium with effusion and tamponade. By utilizing tomotherapy we were able to treat the pericardium while sparing much of the myocardium. The patient tolerated treatment well without acute adverse effects. His symptoms were alleviated, but he died approximately 1 year later.
Authors:
Daniel R Toms; Leander Cannick; Robert K Stuart; Joseph M Jenrette; Lacy Terwiliger
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-07-27
Journal Detail:
Title:  Japanese journal of radiology     Volume:  28     ISSN:  1867-108X     ISO Abbreviation:  Jpn J Radiol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101490689     Medline TA:  Jpn J Radiol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  476-8     Citation Subset:  IM    
Affiliation:
Department of Radiation Oncology, Medical University of South Carolina, 169 Ashley Avenue, Charleston, SC 29425, USA. toms@musc.edu
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MeSH Terms
Descriptor/Qualifier:
Fatal Outcome
Heart Diseases / etiology,  radiotherapy*
Hematopoiesis, Extramedullary / radiation effects*
Humans
Leukemia, Myeloid / complications*
Male
Middle Aged
Pericardium / radiation effects*
Tomography, Spiral Computed / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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