strontium-radioisotopes and Leukemia--Myeloid--Acute

Strontium-89 is a pure Beta-emitting radioactive analogue of calcium that has been shown to be beneficial in the palliation of pain due to osseous metastases from adenocarcinoma of the prostate. The most significant reported toxicity is dose-related, reversible, myelosuppression characterized primarily by thrombocytopenia.. A report of two patients in whom acute myelogenous leukemia (AML) developed after treatment with strontium-89 and a review of the literature are presented.. The two patients described in the current study developed AML 17 months and 26 months, respectively, after exposure to strontium-89 for the treatment of prostate carcinoma. To the authors' knowledge these patients represent the first two reported cases of AML after strontium-89 therapy for prostate carcinoma.. The results of the current study suggest the leukemogenic potential of strontium-89 treatment in humans. To the authors' knowledge, the current study represents the first report of AML after therapeutic exposure to strontium-89. As this agent is used more frequently (and earlier in the disease course) in patients with prostate carcinoma, an increased incidence of secondary AML complicating the clinical management of patients with prostate carcinoma may be observed. [See editorial on pages 497-9, this issue.]

Topics: Adenocarcinoma; Aged; Beta Particles; Bone Neoplasms; Dose-Response Relationship, Radiation; Fatal Outcome; Follow-Up Studies; Humans; Leukemia, Myeloid, Acute; Leukemia, Radiation-Induced; Male; Neoplasms, Second Primary; Palliative Care; Prostatic Neoplasms; Radiopharmaceuticals; Strontium Radioisotopes; Thrombocytopenia

Topics: Blood Cells; Cesium Isotopes; Clinical Trials as Topic; Cobalt Radioisotopes; Cytidine; Erythrocytes; Extracorporeal Circulation; Hematocrit; Humans; Immunosuppression Therapy; Isotope Labeling; Kinetics; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Lymphocytes; Methotrexate; Radiation Effects; Radioisotope Teletherapy; Radioisotopes; Radiotherapy Dosage; Reticulocytes; Strontium Radioisotopes; Thymidine; Tritium; Yttrium Isotopes

Topics: Antineoplastic Combined Chemotherapy Protocols; Carcinoma; Humans; Leukemia, Myeloid, Acute; Leukemia, Radiation-Induced; Male; Neoadjuvant Therapy; Neoplasms, Second Primary; Prostatic Neoplasms; Radiopharmaceuticals; Risk Factors; Strontium Radioisotopes

Topics: Adenocarcinoma; Brachytherapy; Humans; Leukemia, Myeloid, Acute; Male; Neoplasms, Radiation-Induced; Neoplasms, Second Primary; Palliative Care; Prostatic Neoplasms; Risk Factors; Strontium Radioisotopes; Time Factors

A transplantable myelogenous leukemia of an inbred Wistar/Furth rat has been established in tissue culture and cloned. The resulting transplantable leukemia line demonstrates in vitro doubling time of 20 hr, colony-forming efficiency of 5% in liquid and methylcellulos-containing medium, and a saturation density of 3.0 x 106 cells/sq cm in liquid medium. Following intraperitoneal inoculation, newborn rats developed solid tumors, ascities, and leukemia with ld50 of5 x 103 cells and mean latency of 60 days. The tumor cell morphology was consistent with that of acute myelogenous leukemia. Histochemical staining for myeloid enzymes revealed no evidence of myeloperoxidase, esterase, or leukocyte alkaline phosphatase; however, fluorescent antibody staining for lysozyme was markedly positive. Serum, urine, and ascitic fluid from rats with transplanted leukemia also contained elevated levels of lysozyme. There was no detectable type-CRNA virus production by this cell line after as long as 100 days in vitro. This inbred rat myelogenous leukemia should provide a useful model for studies of chemotherapy and immunoltherapy of human acute myelogenous leukemia.

Topics: Animals; Animals, Newborn; Ascitic Fluid; Cell Division; Cell Line; Culture Media; Culture Techniques; Disease Models, Animal; DNA; Female; Fluorescent Antibody Technique; Histocytochemistry; Leukemia, Experimental; Leukemia, Myeloid, Acute; Leukocytes; Muramidase; Pregnancy; Rats; Retroviridae; RNA-Directed DNA Polymerase; Staining and Labeling; Strontium Radioisotopes; Urine

Topics: Aged; Aspergillosis; Autopsy; Cytarabine; Daunorubicin; Diagnosis, Differential; Humans; Leukemia, Myeloid, Acute; Lung; Male; Radionuclide Imaging; Remission, Spontaneous; Strontium Radioisotopes

Topics: Animals; Antibody Formation; Basophils; Bone Marrow; Hematopoietic Stem Cells; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukemia, Radiation-Induced; Lymphoma; Primary Myelofibrosis; Radiation Effects; Strontium Radioisotopes; Swine; Swine Diseases