Hypothyroidism after 131I-monoclonal antibody treatment of neuroblastoma Journal Article
| Authors: | Bhandari, S.; Cheung, N. K. V.; Kushner, B. H.; Kramer, K.; Modak, S.; Larson, S. M.; Yeh, S.; Heller, G.; Sklar, C. A. |
| Article Title: | Hypothyroidism after 131I-monoclonal antibody treatment of neuroblastoma |
| Abstract: | Background. To determine the prevalence of and risk factors for primary hypothyroidism following treatment with a radiolabeled monoclonal antibody (131I-3F8) in children with neuroblastoma. Procedure. In the current study, we assessed thyroid function in 51 neuroblastoma patients who survived for ≥3 months after treatment with 131I-3F8 (a murine IgG3 monoclonal antibody that reacts with the ganglioside GD2) at 4 mCi/kg/dayx5 days (total 20 mCi/kg). Prior therapy in all subjects included dose-intensive chemotherapy; 13 subjects also received external beam radiation to the neck. Oral iodide and liothyronine sodium (T3) were administered for protection of the thyroid gland. Results. Thirty-two of 51 subjects (63%) developed hormonal evidence of primary hypothyroidism. The median time to hypothyroidism after treatment with 131I-3F8 was 6.4 months. The probability of developing hypothyroidism was 56% at 2 years following treatment with 131I-3F8. There was evidence for an association between thyroidal uptake of 131I and development of hypothyroidism (hazard ratio 1.83, 95% confidence interval 0.91-3.30; P=0.09). Conclusions. We conclude that hormonal evidence of primary hypothyroidism developed in a majority of subjects treated with 131I-3F8, despite pretreatment with oral iodide plus liothyronine sodium. Alternative strategies for thyroid gland protection are needed. © 2010 Wiley-Liss, Inc. |
| Keywords: | adolescent; adult; child; controlled study; preschool child; school child; child, preschool; survival rate; young adult; unclassified drug; major clinical study; multimodality cancer therapy; antineoplastic agents; radiation dose; combined modality therapy; antineoplastic agent; prevalence; risk factor; monoclonal antibody; antibodies, monoclonal; immunotherapy; immunoglobulin g; radioactive iodine; iodine radioisotopes; infant; neuroblastoma; external beam radiotherapy; hypothyroidism; thyroid gland; peripheral nerve tumor; liothyronine; peripheral nervous system neoplasms; monoclonal antibody 3f8 i 131; primary hypothyroidism; radiolabeled monoclonal antibody; iodide; 3f8 antibody; thyroid function |
| Journal Title: | Pediatric Blood and Cancer |
| Volume: | 55 |
| Issue: | 1 |
| ISSN: | 1545-5009 |
| Publisher: | Wiley Periodicals, Inc |
| Date Published: | 2010-07-15 |
| Start Page: | 76 |
| End Page: | 80 |
| Language: | English |
| DOI: | 10.1002/pbc.22452 |
| PUBMED: | 20213847 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: PBCEA" - "Source: Scopus" |
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