Splenic re-irradiation for waldenstrőm’s macroglobulinemia

Abstract

We report on a case of Waldenström’s macroglobulinemia (WM) treated with splenic re-irradiation. To the best of our knowledge this has not been reported before. A 69-year-old Asian female patient with WM received a three-dimensional conformal radiotherapy, with 24 Gy in 12 treatment fractions in the first stage. She tolerated the treatment well, with a 37% reduction of the monoclonal immunoglobulin, an impalpable spleen, and improved hematological laboratory tests for 4 months. She was then treated with splenic re-irradiation up to 24 Gy for tumor progression. She showed no evidence of progression one year after re-irradiation, with a 55% reduction of the monoclonal immunoglobulin. Our experience demonstrates that splenic irradiation is an effective treatment to control the progression of WM.

Low-dose splenic irradiation in symptomatic congestive splenomegaly: report of five cases with literature data

“…The exact mechanism how splenic irradiation exerts its effects in splenomegaly is poorly understood. While splenic irradiation is usually considered as a local treatment only with direct effects on the spleen, it also induces systemic effects, which includes problematic symptoms and life-threatening pancytopenia; mechanisms believed to contribute to these effects include direct radiation-induced cell death, immune modulation via selective reduction in lymphocyte subsets, and cytokine induction [ 13 , 14 ].…”