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01-02-2018 | Original Article

Radiotherapy for extramedullary leukaemic manifestation (Chloroma)

Authors: Michael Oertel, MD, Khaled Elsayad, MD, Prof. Uwe Haverkamp, PhD, Prof. Matthias Stelljes, MD, Prof. Hans Theodor Eich, MD

Published in: Strahlentherapie und Onkologie | Issue 2/2018

Abstract

Purpose

Extramedullary leukaemic disease (EMD, synonym chloroma) is a rare solid manifestation of myeloid leukaemia for which the value of radiotherapy (RT) as a treatment strategy remains controversial. The aim of this study is to analyse the effectiveness of various RT doses for EMD in the modern treatment era.

Materials and methods

Between January 2000 and June 2016, 20 patients with total of 45 lesions underwent RT for EMD at our institution.

Results

With a median radiation dose of 26 Gy (range 4–42 Gy), local remission could be achieved in 91% of patients (complete remission rate: 71%). The median duration of local control (DOLC) was 17 months (95% confidence interval [CI] 0.5–33) and the median overall survival (OS) after chloroma onset was 24 months (95% CI 11–38). No noticeable difference between high- and low-dose regimens has been observed (74% versus 68%; P = 0.5). In the multivariate analysis, only Eastern Cooperative Oncology Group (ECOG) score and bone marrow state during RT have proven to be determinant for durable local control and OS.

Conclusions

Low-dose RT (≤26 Gy) achieves good local control compared to high-dose regimes. Bone marrow state during RT and ECOG score during RT may play a crucial role, influencing both DOLC and OS.

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Title: Radiotherapy for extramedullary leukaemic manifestation (Chloroma)
Authors: Michael Oertel, MD
Khaled Elsayad, MD
Prof. Uwe Haverkamp, PhD
Prof. Matthias Stelljes, MD
Prof. Hans Theodor Eich, MD
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 2/2018
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-017-1236-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Radiotherapy for extramedullary leukaemic manifestation (Chloroma)

Abstract

Purpose

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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