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Repeated Radiosynovectomy in Haemophilia: Revealing Long-Term Effectiveness and Safety
Basak Koc1, Cuneyt Turkmen2, Gokhan Polat3
1Hereditary Bleeding Disorders Unit, Istanbul University Oncology Institute, Istanbul, Turkey.
Introduction:
Radiosynovectomy (RS), which uses beta particle-emitting radiocolloids, has proven highly effective in significantly reducing the occurrence of haemarthroses and breaking the cycle of bleeding and synovitis. This study now presents the long-term outcomes of repeated RS in individuals with haemophilia.
Materials And Methods:
Repeated RS was administered to 48 joints in 37 people with haemophilia (PwHs) diagnosed with chronic haemophilic synovitis. The frequency of bleeding episodes was meticulously recorded during the 6-month periods preceding and following each of the initial and subsequent RS procedures. Treatment failure was designated by the necessity for additional RS injections.
Results:
The results for 48 joints were analysed. The mean bleeding frequency of the joints was 12.5 ± 7.29 (median 10) within the last 6 months in the pre-treatment evaluation and after the treatment, the mean bleeding frequency of the joints decreased to 2.25 ± 3.82 (median 0.5) for the first 6 months (p < 0.001) after the first RS. The mean survival of the first intervention was 40.52 ± 33.79 months (range, 1-124 months). In the second RS, the mean bleeding frequency of the joints was 10.29 ± 7.66 (median 8) within the last 6 months in the pre-treatment evaluation and after the treatment, and the mean bleeding frequency of the joints decreased to 0.93 ± 1.69 (median 0) for the first 6 months (p < 0.001). The survival rate of the second RS was 94% at 12 months, and 87% at 36 months.
Conclusion:
Repeated RS was proven to be an effective and safe treatment for Pwh with recurrent bleeding episodes during long-term follow up. Thirty-six months survival rate was 87% (42 of 48 joints).
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