Splenic irradiation for chronic autoimmune thrombocytopenic purpura in patients with contra‐indications to splenectomy

Summary We treated by splenic irradiation eight patients with chronic idiopathic thrombocytopenic purpura (ITP, seven cases) or secondary autoimmune thrombocytopenic purpura (one case) who had contra‐indications to splenectomy. A total dose of 15 Gy was delivered to the spleen, with left kidney protection. One patient had a good durable response (>1 year); two patients had a good transient response (of 3 months duration) but they responded again to a second course of irradiation; two patients had only partial response, but have required no other treatments for 2 years; the three remaining patients had no response. Side‐effects were minor. Therefore splenic irradiation appears to be a therapeutic option in patients with chronic ITP who have contra‐indications to splenectomy.