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J Nucl Med. 2008; 49 (Supplement 1):322P
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Oncology-Basic Science: Therapy, Metrics & Intervention

Therapy, Metrics & Intervention Posters

Factors affecting hematotoxicity after 90Y-ibritumomab tiuxetan or 131I-tositumomab radioimmunotherapy

Sébastien Baechler1, Robert Hobbs1, Heather Jacene1, Andrew Prideaux1, Richard Wahl1 and George Sgouros1

1 Department of Radiology, Johns Hopkins University, Baltimore, Maryland

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Objectives: Hematotoxicity is a major concern for radioimmunotherapy (RIT) and has been associated with individual patient treatment history and variable marrow reserve. This work investigates clinical factors that may influence hematotoxicity after RIT.

Methods: Platelet (PLT) and neutrophil counts (ANC) were available for 32 patients (14 90Y-ibritumomab tiuxetan and 18 131I-tositumomab) at baseline and weekly for 12 weeks post-RIT. Absolute nadir value (ANV) and maximum percentage decline (MPD) from baseline were used as toxicity indices. A post-nadir recovery (PNR) parameter defined as the count percent to baseline 4 weeks after nadir divided by MPD was also used. Multiple linear regression analysis was performed separately for ANV, MPD and PNR to identify statistically significant factors from 12 predicators.

Results: Pooled and separate analyses of 90Y-ibritumomab tiuxetan and 131I-tositumomab data yielded time since last chemotherapy (TLC) as the only significant (p<0.05) variable affecting MPD and PNR. Factors such as number of prior chemotherapy regimens, bone marrow (BM) absorbed dose, BM involvement, BM transplant and prior radiotherapy were not significant. Linear regression gave the following equations for PLT: MPD=97–3.0xTLC (R2=0.6) and PNR=0.15xTLC–0.02 (R2=0.6). Weaker correlations were found for ANC.

Conclusions: Time since last chemotherapy was a strong predicator of hematotoxicity. The increased toxicity for short TLC supports the hypothesis that hematopoietic stem/progenitor cells are hyper-proliferative and more radiosensitive immediately after chemotherapy and less so with increasing time post-chemotherapy. These results should be considered when planning RIT for individual patients.





This Article
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Right arrow Email this article to a friend
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Right arrow Alert me to new issues of the journal
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Google Scholar
Right arrow Articles by Baechler, S.
Right arrow Articles by Sgouros, G.
PubMed
Right arrow Articles by Baechler, S.
Right arrow Articles by Sgouros, G.