phosphorus-radioisotopes and Thrombocytopenia

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; 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

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

Two patients with polycythemia vera received intravenously an accidental tenfold overdosage of radiophosphorus therapy (60 and 50 mCi 32P, respectively). In both patients, the occurrence of hemorrhagic complications 3 wk after the 32P medication led to detection of the error and referral to our hospital. Upon admission they showed an agranulocytosis, severe thrombocytopenia, and bone marrow aplasia. In both cases, spontaneous recovery of the hematopoiesis was observed from day 40 posttreatment onward. In one patient, a slow but ultimately complete normalization of blood counts and marrow morphology took place, whereas in the other, a mild thrombocytopenia persists. Nearly 5 yr after the accidental overdosage, both patients are clinically well. Symptoms of polycythemia vera have not reappeared up to now. Attempts were made to evaluate the radiation dose absorbed by the bone marrow. In the first patient, the daily 32P excretion was determined from day 22 to day 60, whereas in the other patient a whole body count was performed on day 78 after administration. From these results, an approximate cumulative bone marrow dose of 10 Sv (1000 rem) could be calculated.

Topics: Aged; Agranulocytosis; Bone Marrow; Bone Marrow Cells; Female; Humans; Medication Errors; Phosphorus Radioisotopes; Polycythemia Vera; Radiation Dosage; Radiation Injuries; Remission, Spontaneous; Thrombocytopenia

In the period of postirradiation bone-marrow activity depression, changes of the 32P incorporation into phospholipids of blood platelets in rabbits after whole-body exposure to 103.2 mC/kg were noted in vitro. Increased incorporation into phosphatidylcholine, phosphatidylethanolamine and sphingomyeline on the 11th day and into phosphatidylserine on the 8th and 11th day were recorded. On the 5th, 8th and 11th days the pattern of incorporation is changed. During this period a pronounced decrease of 32P incorporation into phosphatidylinositols of the blood platelets was noted, no changes in the representation of the phospholipids of interest (PC, PE, SM, PS, PI) were observed and no alterations of the blood platelet adhesiveness were found. The PF3-A and PF3-F test did not reveal any significant changes of the role of PF 3 in the blood clotting process.

Topics: Animals; Blood Platelets; Male; Phosphatidylcholines; Phosphatidylethanolamines; Phosphatidylinositols; Phosphatidylserines; Phospholipids; Phosphorus Radioisotopes; Rabbits; Sphingomyelins; Thrombocytopenia; Time Factors

Erythrocytosis in a young Sinhalese man is described. The patient was known to have had a raised Hb and PCV for at least 10 years. Subsequent investigations failed to support the diagnosis of polycythaemia vera or to reveal a cause for secondary polycythaemia. Blood erythropoietin values were raised, but no cause for inappropriate secretion could be identified. Although there was no evidence of erythrocytosis in the family, the findings in this patient appear to be those of a condition which has been called familial polycythaemia. The spleen was unusually large and was associated with hypersplenism and thrombocytopenia. Problems of diagnosis and management are described. Phlebotomy appears to be the treatment of choice, with a regimen of regular venesection for the control of symptoms due to hyperviscosity and vascular occlusion.

Topics: Adult; Blood Cell Count; Blood Viscosity; Bloodletting; Diagnosis, Differential; Erythropoietin; Humans; Hypersplenism; Male; Phosphorus Radioisotopes; Polycythemia; Polycythemia Vera; Radionuclide Imaging; Thrombocytopenia

Topics: Adult; Biopsy, Needle; Blood Cell Count; Blood Platelets; Blood Transfusion; Bone Marrow; Cell Survival; Contraceptives, Oral; Depression, Chemical; Drug Combinations; Female; Humans; Isoflurophate; Megakaryocytes; Menstruation; Mestranol; Microscopy, Phase-Contrast; Norethindrone; Phosphorus Radioisotopes; Prednisone; Pregnancy; Splenectomy; Thrombocytopenia; Time Factors

Topics: Administration, Oral; Aged; Bone Neoplasms; Female; Hematopoiesis; Humans; Injections, Intravenous; Male; Middle Aged; Neoplasm Metastasis; Phosphorus Radioisotopes; Prostatic Neoplasms; Spinal Cord Compression; Spinal Neoplasms; Testosterone; Thrombocytopenia

Topics: Adolescent; Black People; Blood Platelets; Bone Marrow Examination; Buffers; Cell Survival; Chromatography; Chromium Radioisotopes; Dextrans; Electrophoresis, Starch Gel; Erythrocytes; Glucosephosphate Dehydrogenase Deficiency; Heinz Bodies; Hemoglobinopathies; Hemoglobins, Abnormal; Hot Temperature; Humans; Iron; Male; Megakaryocytes; Phosphorus Radioisotopes; Splenectomy; Splenomegaly; Thrombocytopenia; Ultracentrifugation