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Multimodal management, including precisely targeted irradiation, in a severe refractory case of Evans syndrome
Author(s) -
Miale Thomas D.,
Wong Jeffrey Y.C.,
Ahmed Imran,
Wagman Lawrence D.
Publication year - 2006
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20976
Subject(s) - medicine , refractory (planetary science) , intensive care medicine , radiation therapy , treatment modality , platelet , therapeutic modalities , surgery , physics , astrobiology
Abstract A challenging case of acute autoimmune thrombocytopenia (ITP) which evolved into a chronic refractory case of Evans syndrome over a period of more than 23 years is presented and may illustrate current therapeutic dilemmas now perplexing patients and clinicians. Newer modalities are being developed and their eventual role in the scheme of clinical management remains to be established. While this development unfolds, highly targeted radiotherapy was applied in this case to reduce platelet uptake by a refractory recurrent splenule with the goal of stabilizing the platelet count until promising investigational thrombopoietic agents or other newer, less toxic therapies might become available for wider application. Pediatr Blood Cancer 2006;47:726–728. © 2006 Wiley‐Liss, Inc.