phosphorus-radioisotopes and Leukopenia

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: Hemorrhagic Disorders; Humans; Leukemia, Radiation-Induced; Leukopenia; Methods; Osteosclerosis; Phosphorus Radioisotopes; Polycythemia Vera; Prognosis; Radiotherapy; Radiotherapy Dosage; Remission, Spontaneous; Thrombocytopenia; Time Factors

The follow-up of a 93-year-old-patient with polycythaemia vera (PV) diagnosed in 1977 is presented. The patient accidentally received a ten-fold overdose of radioactive P32 due to an incorrectly labelled vial. 14 days after the administration of the overdose of P32, the patient was admitted to the University Hospital of Zurich with bone marrow aplasia. She recovered from the aplasia within 6 weeks. During the following 15 years she has suffered no relapse nor developed leukemia as a secondary complication.

Topics: Aged; Aged, 80 and over; Bone Marrow Diseases; Drug Overdose; Female; Follow-Up Studies; Humans; Leukopenia; Medication Errors; Phosphorus Radioisotopes; Polycythemia Vera; 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 blood lymphocyte population was examined in 34 patients who were treated with 131I for toxic or atoxic nodular goitre. One to three doses of 300-550 MBq of 131I were administered at 1-week intervals. Lymphocyte counts were found to be significantly reduced at both 1 and 6 weeks after treatment. This decrease was accompanied by a changed composition of the lymphocyte subpopulations. The frequency of lymphocytes expressing membrane receptors for C'3 (EAC-rosette forming cells) was significantly reduced at 1 and 6 weeks following 131I administration. At 6 weeks there was a small but statistically significant increase of the frequency of T cells as identified by Leu 1 monoclonal antibodies. This was essentially due to an increased proportion of helper/inducer T cells as identified by Leu 3 monoclonals. 131I treatment also decreased the capacity of lymphocytes to secrete immunoglobulins (Ig) when stimulated with pokeweed mitogen (PWM). The greatest effect was observed for IgM. Secretion of IgG and IgA were less reduced. Mitogenic stimulations of lymphocytes with phytohemagglutinin (PHA) and concanavalin A were not significantly changed. It is concluded that these findings, with the exception of mitogen reactivity, are largely similar to those occurring following external radiation therapy for cancer. It is suggested that blood lymphocytes passing through the continuously irradiated gland are damaged mainly by beta-rays. The effect of 32P treatment on the blood lymphocyte population was examined in 16 patients with polycythemia vera. Before treatment the lymphocyte counts were within the normal range but the expression of certain membrane structures, as identified by monoclonal antibodies against total T cells (Leu 1 and 4), helper/inducer (Leu 3) and suppressor/cytotoxic T cells (Leu 2), were slightly decreased. Moreover, mitogenic responses of the lymphocytes to PHA and PWM-induced Ig secretion were impaired. Following a single oral dose of 32P (150-305 MBq), which normalized the production of erythrocytes and/or platelets, the blood lymphocyte counts were reduced by approximately 40 per cent 12 weeks after treatment. Examination of subsets demonstrated that the proportion of B-cells, as identified by B1 monoclonal antibodies, was decreased by the highest relative extent. On the other hand, lymphocytes expressing the above-mentioned T cell markers were somewhat increased. 32P treatment markedly increased PHA reactivity but it further reduced PWM-induced I

Topics: Aged; Aged, 80 and over; Antibody Formation; Female; Goiter, Nodular; Humans; Iodine Radioisotopes; Lectins; Leukocyte Count; Leukopenia; Lymphocyte Activation; Lymphocytes; Male; Middle Aged; Phosphorus Radioisotopes; Polycythemia Vera

Topics: Cobalt Radioisotopes; Gold Radioisotopes; Humans; Iodine Radioisotopes; Leukopenia; Male; Methods; Phosphorus Radioisotopes; Prostatic Neoplasms; Radiotherapy Dosage; Rectal Diseases; Time Factors; Ulcer; Urethral Stricture; Urinary Calculi

The prevention of recurrences of bladder cancer was attemped in 48 patients by means of the combined intravesical instillation of thio-tepa and urokinase and in 28 patients through the instillation of thio-tepa alone. The recurrence rates of both therapies for the postoperative 18 months were 7.9 and 32.6 per cent, respectively, indicating a significant drop in the recurrence rate in the group subjected to the combined therapy. No significant difference was found between the 2 instillation groups in terms of the blood transmission of 32-P thio-tepa. Serious leukopenia was found in 2 of the 48 patients receiving the combined instillation therapy but we concluded that this was not attributable to the use of urokinase.

Topics: Adolescent; Adult; Aged; Carcinoma, Transitional Cell; Cystitis; Drug Therapy, Combination; Endopeptidases; Female; Hemorrhage; Humans; Leukopenia; Male; Middle Aged; Neoplasm Recurrence, Local; Phosphorus Radioisotopes; Thiotepa; Urinary Bladder Diseases; Urinary Bladder Neoplasms; Urokinase-Type Plasminogen Activator