Letter to the Editor

Thrombocytopenia Following 90Yttrium Glass Microsphere Liver Radioembolization

Authors: Pawan Gundavaram, MD, Ron C. Gaba, MD

Abstract

To the Editor: We read with interest the article by Yang et al1describing a case of profound transient thrombocytopenia after 90Yttrium resin microsphere therapy for surgically unresectable hepatocellular carcinoma (HCC). We have also recently encountered this uncommon adverse sequella of liver radioembolization after 90Yttrium glass microsphere (TheraSphere®; MDS Nordion, Ottawa, Canada) administration, and present it herein.

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References

1. Yang CW, Yen HH, Su WW, et al. Profound transient thrombocytopenia associated with 90Yttrium microsphere therapy for inoperable hepatoma. South Med J 2010;103:1264-1268.
 
2. Schull WJ. Effects of Atomic Radiation: A Half-Century of Studies from Hiroshima and Nagasaki. New York, J Wiley, 1996.
 
3. Salem R, Thurston KG. Radioembolization with 90Yttrium microspheres: a state-of-the-art brachytherapy treatment for primary and secondary liver malignancies. Part 1: technical and methodologic considerations. J Vasc Interv Radiol 2006;17:1251-1278.
 
4. Aster RH. Pooling of platelets in the spleen: role in the pathogenesis of "hypersplenic" thrombocytopenia. J Clin Invest 1966;45:645-657.
 
5. Fliedner TM, Friesecke I, Beyrer K. Medical Management of Radiation Accidents: Manual on the Acute Radiation Syndrome. London, The British Institute of Radiology, 2001.