Palliative Radiotherapy for Spinal Extramedullary Hematopoiesis in Thalassemia Major

Introduction: Non-hepatosplenic Extramedullary Hematopoiesis (NHEMH) is seen as a compensation mechanism in the patients with hematologic dysfunction. Thalassemia is an autosomal recessive hematologic disorder. The tissue involvement is seen very rarely in thalasemia major.

Case: A 45-years old patient diagnosed with thalassemia major was presented in this case report. The patient had splenectomy after 12 years from diagnosis and he was followed with continuous blood transfusions. Due to the newly emerged chest pain and dyspnea, he was evaluated with computed tomography. The operation was done for paraspinal masses caused by NHEMH. But same complaints were seen after 5 years from the operation. Paraspinal and sacral recurrences were detected in screening examinations. External palliative radiotherapy (ERT) was given to the patient with 3000 cGy total doses. Both clinical and radiological response was obtained with ERT.

Conclusion: Radiotherapy might be considered as an efficient palliative treatment option for the thalassemia major patients with NHEMH masses recurring after operation.