Extramedullary Hematopoiesis in a Patient with Transfusion Dependent Beta-Thalassemia Presenting with Cord Compression

Extramedullary hematopoiesis (EMH) is a physiological compensatory phenomenon occurring in many hemolytic anemias including thalassemia. Besides transfusion, radiotherapy, surgery or a combination of these modalities, hydroxyurea (HU) as an optimal treatment has been described occasionally. We described a case of beta-thalassemia major who has been on regular blood transfusion and developed EMH that was treated with HU combined with radiotherapy. EMH should also be considered in thalassemia major patients, although it is more common in non-transfusion dependent thalassemia patients. HU combined with low dose radiotherapy along with regular blood transfusion are suggested as good treatment options for patients with EMH.