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20.04.2020 | Interventional Radiology

Durability of partial splenic artery embolization on platelet counts for cancer patients with hypersplenism-related thrombocytopenia

verfasst von: Ashley Hill, Ahmed Elakkad, Joshua Kuban, Sharjeel Sabir, Bruno Odisio, Steven Y. Huang, Armeen Mahvash, Ethan Miller, Michael H. Kroll, Michael Overman, Alda L. Tam, Sanjay Gupta, Rahul A. Sheth

Erschienen in: Abdominal Radiology | Ausgabe 9/2020

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Abstract

Purpose

Partial splenic artery embolization (PSAE) has shown promise in increasing platelet counts in cancer patients with hypersplenism-related thrombocytopenia. The purpose of this study was to identify response predictors and to longitudinally evaluate PSAE efficacy and durability in a large cohort of cancer patients with hypersplenism-related thrombocytopenia.

Methods

A single-institution, IRB-approved, HIPAA-compliant retrospective review of all PSAEs for thrombocytopenia between 2012 and 2015 was performed. Patients were classified as complete responders (CR, no platelet value < 100 × 10⁹/L following PSAE), partial responders (PR, initial increase in platelets but subsequent decrease in platelets < 100 × 10⁹/L), and non-responders (NR, platelets never > 100 × 10⁹/L following PSAE).

Results

Of the 98 patients included in the study, 58 had CR (59%), 28 had PR (29%), and 12 patients had NR (12%). The percent splenic tissue embolized was significantly greater in the CR group compared to the PR group (P = 0.001). The percent volume of splenic tissue embolized was linearly correlated with the magnitude of platelet increase without a minimum threshold. At least one line of chemotherapy was successfully restarted in 97% of patients, and 41% of patients did not experience recurrence of thrombocytopenia for the duration of their survival. The major complication rate was 8%, with readmission following initial hospitalization for persistent “post-embolization syndrome” symptoms the most common.

Conclusions

In cancer patients with hypersplenism-related thrombocytopenia, PSAE is a safe intervention that effects a durable elevation in platelet counts across a range of malignancies and following the re-initiation of chemotherapy.

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Titel: Durability of partial splenic artery embolization on platelet counts for cancer patients with hypersplenism-related thrombocytopenia
verfasst von: Ashley Hill
Ahmed Elakkad
Joshua Kuban
Sharjeel Sabir
Bruno Odisio
Steven Y. Huang
Armeen Mahvash
Ethan Miller
Michael H. Kroll
Michael Overman
Alda L. Tam
Sanjay Gupta
Rahul A. Sheth
Publikationsdatum: 20.04.2020
Verlag: Springer US
Erschienen in: Abdominal Radiology / Ausgabe 9/2020
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-020-02523-5

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Durability of partial splenic artery embolization on platelet counts for cancer patients with hypersplenism-related thrombocytopenia

Abstract

Purpose

Methods

Results

Conclusions

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Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

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