Complete blood counts are frequently abnormal 1 year after dosimetry-guided radioactive iodine therapy for metastatic thyroid cancer Journal Article

Authors: Padovani, R. P.; Tuttle, R. M.; Grewal, R.; Larson, S. M.; Boucai, L.
Article Title: Complete blood counts are frequently abnormal 1 year after dosimetry-guided radioactive iodine therapy for metastatic thyroid cancer
Abstract: Objective: Radioactive iodine (RAI) has been associated with hematologic abnormalities. Previous research has shown that even a single dose of RAI can cause changes in the peripheral complete blood count (CBC). It is unclear if the use of dosimetry guidance would prevent the effects of high doses of RAI on bone marrow suppression. Methods: CBC at baseline was compared to a CBC obtained 1 year after the last RAI treatment in 50 thyroid cancer patients that received ≥250 mCi RAI during the course of their disease. Cumulative dose, number of treatments, patients' age, and the use of external beam radiation therapy (EBRT) were considered in the analysis. Results: We observed a small but statistically significant decrease in hemoglobin (Hb), hematocrit (Hct), and platelet (Plt) counts at 1 year in 50 patients who had received ≥250 mCi RAI. We did not find a significant change in white blood cell count (WBC). Approximately 60% of patients who developed anemia had concomitant WBC and Plt abnormalities. RAI dose, number of treatments, and age at diagnosis did not confer a higher risk of bone marrow suppression. Conclusion: High cumulative activities of RAI administered under dosimetric guidance are associated with a small but statistically significant decreases in Hb, Hct, and Plt counts. The clinical implications of these changes, if any, are unclear. The benefits obtained with high doses of RAI, when indicated, are likely to outweigh the minimal hematologic risks observed in the present study. Copyright © 2014 AACE.
Keywords: adult; clinical article; controlled study; middle aged; disease course; cancer risk; cancer radiotherapy; radiation dose; follow up; treatment indication; anemia; bone marrow suppression; incidence; hemoglobin; radiation response; risk assessment; radioactive iodine; dosimetry; thrombocyte count; thyroid cancer; external beam radiotherapy; blood cell count; leukocyte count; hematocrit; hemoglobinopathy; thrombocyte anomaly; erythrocyte disorder; human; male; female; article; dosimetry guided radioactive iodine therapy; leukocyte disorder
Journal Title: Endocrine Practice
Volume: 20
Issue: 3
ISSN: 1530-891X
Publisher: American Association of Clinical Endocrinologists  
Date Published: 2014-03-01
Start Page: 213
End Page: 220
Language: English
DOI: 10.4158/ep13172.or
PROVIDER: scopus
PUBMED: 24126230
Notes: Export Date: 1 May 2014 -- CODEN: EPNRA -- Source: Scopus
Altmetric Score
MSK Authors
  1. Robert M Tuttle
    350 Tuttle
  2. Ravinder K Grewal
    57 Grewal
  3. Steven M Larson
    765 Larson
  4. Laura   Boucai
    12 Boucai