Application de la radiothérapie dans les hémopathies malignes : expérience du pôle d’onco-hématologie de l’hôpital Dalal Jamm de Dakar

Abstract

INTRODUCTION: The treatment of hematologic malignancies is based on chemotherapy and/or targeted therapies. The place of radiotherapy was once highly debated because it could be responsible for significant late toxicity, but the progress of recent years has made practices evolve in the direction of the integration of radiotherapy in the multidisciplinary management of these malignant hemopathies. .We report the profile of malignant haematological pathologies, the indications for radiotherapy and its impact in improving the care of patients in the onco-hematology center of the Dalal Jamm Hospital in Dakar. MATERIALS AND METHODS: All patients treated with curative or palliative radiotherapy in the radiotherapy department of Dalal Jamm Hospital in Dakar for a malignant hemopathy duly diagnosed between June 2018 and July 2021 were retrospectively included. RESULTS: From June 2018 to July 2021, 20 patients with malignant hemopathy were treated in the radiotherapy department. These 11 men and 9 women had a mean age of 50.1 years ± 15.6. The main malignant haematological pathologies were lymphomas (6 cases) including 2 cases of non-Hodgkin's type, 4 cases of multiple myeloma, 6 cases of solitary plasmacytoma, 2 cases of multiple myeloid associated with a solitary plasmacytoma, 1 case of chronic lymphoid leukemia and 1 case of myeloid splenomegaly. The indication for radiotherapy was curative in the cases of Hodgkin lymphoma and solitary plasmacytoma and palliative in the remainder. The dose was 36 Gy in 18 fractions for Hodgkin lymphoma, 30 Gy in 10 fractions for cases of solitary plasmacytomas in exclusive irradiation, 20 Gy in 5 fractions for plasmacytomas in consolidation after resection and 8 Gy in one fraction for analgesic treatments. With a mean follow-up of 23 months, we noted three deaths including the case of myeloid splenomegaly, chronic lymphoid leukemia and one case of multiple myeloma associated with a solitary plasmacytoma. The rest of the patients were in remission. CONCLUSION: Radiotherapy, with to its technical progress, has gained in precision and retains a place in the multidisciplinary management of hematologic malignancies. KEYWORDS: Hematologic malignancies; Radiotherapy; Senegal.