Caulier M T, Darloy F, Rose C, Camier G, Morel P, Bauters F, Fenaux P
Service des Maladies du Sang, C.H.U. Lille, France.
Br J Haematol. 1995 Sep;91(1):208-11. doi: 10.1111/j.1365-2141.1995.tb05271.x.
We treated by splenic irradiation eight patients with chronic idiopathic thrombocytopenic purpura (ITP, seven cases) or secondary autoimmune thrombocytopenic purpura (one case) who had contra-indications to splenectomy. A total dose of 15 Gy was delivered to the spleen, with left kidney protection. One patient had a good durable response (> 1 year); two patients had a good transient response (of 3 months duration) but they responded again to a second course of irradiation; two patients had only partial response, but have required no other treatments for 2 years; the three remaining patients had no response. Side-effects were minor. Therefore splenic irradiation appears to be a therapeutic option in patients with chronic ITP who have contra-indications to splenectomy.
我们对8例有脾切除禁忌证的慢性特发性血小板减少性紫癜（ITP，7例）或继发性自身免疫性血小板减少性紫癜（1例）患者进行了脾脏照射治疗。脾脏接受的总剂量为15 Gy，同时对左肾进行保护。1例患者有良好的持久反应（>1年）；2例患者有良好的短暂反应（持续3个月），但对第二疗程照射再次有反应；2例患者仅有部分反应，但2年来无需其他治疗；其余3例患者无反应。副作用轻微。因此，对于有脾切除禁忌证的慢性ITP患者，脾脏照射似乎是一种治疗选择。
