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Safety of radiation exposure after radiosynovectomy in paediatric patients with haemophilia
Author(s) -
RodriguezMerchan E. C.,
Valentino L. A.
Publication year - 2015
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/hae.12668
Subject(s) - medicine , haemophilia , synovitis , haemophilia a , pediatrics , arthritis
Summary Many paediatric patients with haemophilia who might benefit from radiosynovectomy ( RS ) for the control of synovitis do not undergo the procedure as there is controversy in the literature regarding the safety of radiation exposure after two cases of acute lymphocytic leukaemia in children with haemophilia treated with 32 P RS were reported. The purpose of this review was to analyse the safety of RS in paediatric patients with haemophilia and provide a risk‐benefit assessment, which practitioners could apply to their patients. Children undergoing knee RS receive a radiation dose of approximately 0.74 mSv (90 megabecquerels‐MBq) and elbow and ankle RS s a dose of approximately 0.32 mSv (30–40 MBq). The radiation dose from natural sources is approximately 2 mSv and the recommended limit for patients (apart from natural sources) is 1 mSv per year. The lifetime cancer risk increases about 0.5% per 100 mSv per year. Considering the risks and benefits of RS , the authors recommend that clinicians consider this procedure in children with inhibitors or in patients without inhibitors when bleeding is recurrent and persistent despite aggressive factor replacement.