phosphorus-radioisotopes and Anemia

Topics: Anemia; Apoptosis; Clone Cells; Disease Progression; Erythropoiesis; Erythropoietin; Female; Growth Substances; Hematologic Tests; Hematopoietic Stem Cells; Humans; Iron; Leukemia, Myeloid; Male; Myeloproliferative Disorders; Phlebotomy; Phosphorus Radioisotopes; Polycythemia Vera; Pregnancy; Pregnancy Complications, Hematologic; Receptors, Erythropoietin; Receptors, Growth Factor; Thrombocytosis; Thrombosis

Supportive care are a strongly connected constituent of the curative and palliative treatment of cancer. They serve for prevention and early diagnosis, respectively, and treatment of complications during therapy and disturbances which may issue from the tumour disease itself. These are especially the results of the insufficiency of the bone marrow which in the last years increasingly moved into the centre of the therapeutic interest. A survey of the present state of the treatment of these and other general complications in patients with malignant neoplasms is given.

Topics: Anemia; Ascites; Blood Coagulation Disorders; Bone Marrow Transplantation; Cross Infection; Granulocytes; Humans; Hypercalcemia; Intracranial Pressure; Leukopenia; Neoplasms; Patient Isolation; Phosphorus Radioisotopes; Pleural Effusion; Thrombocytopenia; Transfer Factor; Transplantation, Autologous; Transplantation, Homologous

Topics: Anemia; Blood Volume; Carbon Radioisotopes; Cardiovascular Diseases; Chromium Radioisotopes; Chronic Disease; Endocrine System Diseases; Erythrocyte Volume; Female; Hematocrit; Humans; Kidney Diseases; Liver Cirrhosis; Lung Diseases; Male; Nutrition Disorders; Phosphorus Radioisotopes; Plasma Volume; Polycythemia; Pregnancy; Technetium; Time Factors

Topics: Anemia; Anemia, Sideroblastic; Animals; Chromosome Aberrations; Chromosome Disorders; Female; Granulocytes; Hematologic Diseases; Humans; Japan; Leukemia; Leukemia, Erythroblastic, Acute; Leukemia, Myeloid, Acute; Male; Mice; Middle Aged; Nuclear Warfare; Phosphorus Radioisotopes; Polycythemia Vera; Precancerous Conditions; Radiation Injuries; Thrombocytopenia

We have evaluated 230 patients with myeloproliferative disorders treated in the last 15 years with 32P. None of the patients affected by essential thrombocythaemia developed haematological complications. In the larger group of polycythaemia patients (214 subjects) only 38 patients (17 males and 21 females) developed complications. 60.5% of these subjects had a minor complications: 1.8% showed a thrombocytopenia lower than 100.10e9/lt, 2.3% anaemia with Hb lower than 10 g%, 2.6% leukopenia lower than 40.10e9/lt and 2.3% a pancytopenia. All these complications were transient and eventually treated with limited blood transfusions. We could not identify a correlation between the dose used and the development of such complications. We noted only that the occurrence of anaemia, given a similar dose, was more frequent in females. Only 7% of all patients presented a major complication after 32P administration. In this case too, there was no correlation with the dose administered. Myelofibrosis and chronic myeloid leukaemia resulted to be the more frequent complication (9 out of 15) but we could not clarify if they represented a natural evolution of polycythaemia vera or were due to the treatment with 32P. Acute leukaemia developed only in 5 patients and again we could not recognized a correlation with the dose administered. Moreover, the time from the diagnosis of polycythaemia vera the onset of acute leukaemia ranged widely. 32P has a definite effect on the prevention of thrombotic and haemorrhagic complications in polycythaemia patients since it prolongs their life but it also increases the incidence of acute leukaemia.

Topics: Anemia; Female; Follow-Up Studies; Hematologic Diseases; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukopenia; Male; Middle Aged; Phosphorus Radioisotopes; Polycythemia Vera; Primary Myelofibrosis; Radiotherapy; Thrombocytopenia

The onset of postpolycythemic myeoloid metaplasia or spent polycythemia has been recognized for many years. As the result of many different series, the development of postpolycythemic myeolid metaplasia might be expected in from 15%-20% of patients with postpolycythemia vera. It appears that an etiologic role for sodium phosphate 32P may exist in this evolutionary pattern. About 70% of patients with PPMM will have symptoms with the onset of the syndrome. The major mechanisms producing symptoms result from (1) anemia, (2) pressure from massive splenomegaly, and (3) bleeding problems. Iron deficiency is a frequent cause of anemia in patients with PPMM. The major mechanism of anemia in these patients, however, relates to ineffective erythropoiesis and shortened red cell survival. Androgen trials for ineffective erythropoiesis seem worthwhile, although data on this point is too limited to draw any firm conclusions. A steroid trial for those patients with major hemolytic episodes is indicated. In those patients in whom adrenal steroid therapy fails to control major hemolysis, a consideration for splenectomy exists. Pressure-related manifestations secondary to massive splenomegaly have been treated with radiation therapy and oral alkylators. Although there is data to document amelioration of painful symptoms with associated shrinking of the spleen, long-term control of this problem has not been forthcoming. Again, patients who are medical failures in control of pressure-related manifestations may be considered for splenectomy. Bleeding problems may arise with PPMM secondary to thrombocytopenia, thrombocythemia, or qualitative platelet dysfunction. Adrenal steroids have met with some success in improving platelet counts in patients with life-threatening thrombocytopenia. Those patients who are medical failures with adrenal steroids in terms of thrombocytopenia might be candidates for splenectomy. Control of thrombocythemia has been observed with oral alkylator therapy and chlorambucil may have a special role in managing this complication. Qualitative platelet defects leading to severe bleeding are best managed with fresh platelet transfusions. Patients with PPMM in contrast to patients with agnogenic myeoloid metaplasia have a more lethal syndrome and shortened survivorship. Causes of death in patients with PPMM include cardiac problems, transition to acute leukemia, hemorrhage, and infection.

Topics: Anemia; Female; Humans; Iron; Male; Phosphorus Radioisotopes; Polycythemia Vera; Prednisone; Primary Myelofibrosis; Splenomegaly

Radionuclide studies of the erythron are valuable to the physician in evaluating the clinical situation in a wide variety of hematologic disorders. A complete and accurate analysis of the life cycle of the red cell can be obtained with a full iron kinetic study, in conjunction with a DF32P red-cell survival study. However, a complete iron kinetic study is not always necessary. It may be abbreviated by deleting the in vitro phase of the iron kinetic procedure. The abbreviated iron kinetic study is also done in conjunction with a DF32P red-cell survival study. It can easily be performed by injecting 59Fe-labeled plasma and monitoring externally over the spleen, liver, and sacrum. Measurements of red-cell survival may be obtained with either 51Cr or DF32P. Although 51Cr provides a relatively uniform label of circulating red cells and is convenient to count in vitro, its highly variable elution rate precludes an accurate measurement of erythrocyte survival. The 51Cr method provides only a rough index of circulating red-cell half-times as a measure of red-cell survival. DF32P, HOWEVER, IS A PERMANENT LABEL OF CIRCULATING RED CELLS. It provides a direct measurement of erythrocyte survival and permits in vivo labeling of red cells simply by means of direct intravenous injection. Because it has an elution rate that is virtually zero after minimal elution on the day of injection, and because it is not reutilized, DF32P is unquestionably the best agent known for the determination of red-cell survival. In addition to these diagnostic data, the complete iron kinetic study can provide data on the deposition of iron in storage and the rate of iron storage exchange. It can also determine if erythropoiesis is quantitatively abnormal and if the abnormality is located in the bone marrow or in other organs such as the liver or spleen. Although the study of hematologic disorders is one of the most rapidly developing areas of medical research, techniques that are currently available can provide an understanding of the life cycle of the red cell and valuable data that can be applied directly to the clinical situation. When performed accurately, these studies provide a thorough analysis of the pathophysiology of the erythron and are valuable clinical tools that can be used successfully in the diagnosis and evaluation of a broad spectrum of hematological disorders.

Topics: Anemia; Anemia, Hemolytic; Anemia, Hemolytic, Autoimmune; Anemia, Hypochromic; Anemia, Pernicious; Bone Marrow Diseases; Cell Survival; Chromium Radioisotopes; Erythrocytes; Hemochromatosis; Hemoglobinuria, Paroxysmal; Hemosiderosis; Humans; Iron Radioisotopes; Isoflurophate; Isotope Labeling; Leukemia; Phosphorus Radioisotopes; Polycythemia Vera; Primary Myelofibrosis; Radioisotopes; Radionuclide Imaging; Spherocytosis, Hereditary; Splenic Diseases; Vitamin E Deficiency

Topics: Adenosine Monophosphate; Anemia; Animals; Base Sequence; Chromatography, Gel; Globins; Pancreas; Phenylhydrazines; Phosphorus Radioisotopes; Polynucleotides; Rabbits; Ribonucleases; Ribonucleotides; RNA, Messenger; Spleen

Topics: Adenosine Monophosphate; Anemia; Animals; Blood Proteins; Bucladesine; Butyrates; Centrifugation, Density Gradient; Cyclic AMP; Electrophoresis, Polyacrylamide Gel; Kinetics; Molecular Weight; Phosphates; Phosphoproteins; Phosphorus Radioisotopes; Rabbits; Reticulocytes; Ribosomes; Structure-Activity Relationship; Time Factors

Topics: Anemia; Animals; Cell Nucleus; Centrifugation, Density Gradient; DNA; Ducks; Electrophoresis, Polyacrylamide Gel; Erythrocytes; Globins; Hemoglobins; Histones; Microscopy, Electron; Nucleoproteins; Phenylhydrazines; Phosphorus Radioisotopes; RNA; Time Factors; Tritium; Uridine

Topics: Acetates; Anemia; Chlorides; Diphosphoglyceric Acids; Erythrocytes; Humans; Hydrogen-Ion Concentration; Kinetics; Phosphorus Radioisotopes; Phosphotransferases; Potassium; Salts; Sodium; Sulfates; Thyroxine

Topics: Anemia; Anemia, Hemolytic; Erythrocytes; Humans; Permeability; Phosphorus; Phosphorus Radioisotopes

Topics: Anemia; Humans; Phosphorus; Phosphorus Radioisotopes; Phosphorus, Dietary; Polycythemia Vera; Radioactivity

Topics: Anemia; Anemia, Aplastic; Humans; Phosphorus; Phosphorus Radioisotopes; Phosphorus, Dietary; Radioactivity; Spleen; Splenectomy

Topics: Anemia; Anemia, Sickle Cell; Humans; In Vitro Techniques; Phosphorus; Phosphorus Radioisotopes; Radioactivity; Sickle Cell Trait

Topics: Anemia; Anemia, Hemolytic; Erythrocytes; Humans; Phosphorus; Phosphorus Radioisotopes