This article is more than 5 years old. Information may no longer be current.
Radionuclide therapy may be linked to hematologic consequences in neuroendocrine tumors
Click Here to Manage Email Alerts
Patients with neuroendocrine tumors who have undergone iodine-131–metaiodobenzylguanidine therapy experience respectable rates of survival, but a minority develops hematological pathologies in long-term follow-up, according to research presented at the Society for Endocrinology BES 2012 meeting.
“We are demonstrating very good survival with a small but defined rate of hematological sequelae,” Maralyn Druce, MA, MRCP, PhD, researcher and senior lecturer and consultant endocrinologist at St. Bartholomew’s Hospital, London, told Endocrine Today. “The next step is to identify which patients are at risk of these [hematological pathologies] and to individualize treatment.”
There are a number of available therapies for neuroendocrine tumors, which can vary in progression from slow to rapid, Druce said.
The best order in which to administer therapies for neuroendocrine tumors remains unclear, she said, adding that with the exception of surgery for non-metastatic disease, therapies for neuroendocrine tumors, such as radionuclide therapy, are not curative and focus on symptom control and extending progression-free survival or overall survival.
For the current study, Druce and colleagues retrospectively reviewed records for 75 patients who received iodine-131–metaiodobenzylguanidine (131I-MIBG) therapy to determine cumulative doses, disease progression, survival and long-term sequelae. The median follow-up was 72 months.
Five patients developed hematological pathologies, ranging from myelodysplasia to frank leukemia, with these pathologies developing at least 5 years after the start of 131I-MIBG therapy.
“Performing longer follow-up allows you to identify the toxicities,” Druce said, noting that other studies with shorter follow-up periods have also reported hematological pathologies but with varying frequency.
She said the five patients who developed hematological pathologies received a total dose higher than the median cumulative dose, which was 17.37 GBq.
“We found an association between the presence of renal impairment and the development of hematological pathologies,” she said.
Future research will aim to identify predictors of sequelae of therapies in order to best individualize treatment for patients with neuroendocrine tumors who receive radionuclide therapy, Druce said. – by Louise Gagnon
Disclosure: Dr. Druce reports no relevant financial disclosures.
For more information:
- Sze W-C. Abstract #OC5.3. Presented at: the Society for Endocrinology BES meeting; March 19-22, 2012; Harrogate, United Kingdom.