phosphorus-radioisotopes and Thromboembolism

Topics: Acute Disease; Adult; Aged; Bloodletting; Busulfan; Evaluation Studies as Topic; Female; Humans; Leukemia; Leukemia, Radiation-Induced; Male; Mercaptopurine; Middle Aged; Phosphorus Radioisotopes; Polycythemia Vera; Thromboembolism; Veins

During the last 12 years, 86 apparently primary polycythemias have been observed in subjects less than 40 years old. In twelve of them a non-suspected cause has been found (seven abnormalities of the hemoglobin function). In 43 cases, all males, the erythrocytosis (red cell volume more than 36 ml/kg) was pure and stable, without any complication; this "benign erythrocytosis" probably depicts extreme values of the normal distribution of the red cell mass. In 31 cases, the disease had criteria similar to those of polycythemia vera observed in older patients; in 12 of these cases, severe thrombo-embolic complications have been observed at the very beginning of the disease; however no further complication has been seen, when the patients were actively treated (phlebotomies or 32P); at the present time, no one of these cases did show transformation into acute leukemia, but the long-term prognosis (beyond 15 years) cannot yet been precisely drawn.

Topics: Adolescent; Adult; Bloodletting; Erythrocyte Volume; Female; Follow-Up Studies; Hemoglobinometry; Hemoglobinopathies; Humans; Male; Myeloproliferative Disorders; Phosphorus Radioisotopes; Polycythemia; Polycythemia Vera; Thromboembolism

Retrospective studies were carried out in 52 patients with polycythemia vera who were treated with radioactive phosphorus (32-P) over periods ranging between 4 and 24 years. Control of hematopoiesis was achieved in all patients. Duration of the remission induced differed considerably in the individual patients. Mean remission lasted 3-4 years. After 13 years of 32-P treatment, the mean duration of remission lengthened due to gradual transition of some cases into "spent" polycythemia. The mean annual dose of 32-P was about 2.4 mCi. In patients with long-term remissions, the dose accumulated per year was markedly less. These patients probably represent optimal preconditions for 32-P therapy. Mean survival was 12.5 years. The majority of the patients died from thorombo-embolie events or hemorrhage; incidence of acute leukemia was about 4%.

Topics: Acute Disease; Adult; Aged; Female; Hemorrhage; Humans; Leukemia; Male; Methods; Middle Aged; Phosphorus Radioisotopes; Polycythemia Vera; Radiotherapy Dosage; Remission, Spontaneous; Splenomegaly; Thromboembolism; Time Factors