Imaging for improved prediction of myelotoxicity after radioimmunotherapy

Diane A. DeNardo, Gerald L Denardo, Robert T O'Donnell, Sang Moo Lim, Sui Shen, Aina Yuan, Sally J. DeNardo

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

BACKGROUND. The severity of myelotoxicity after radioimmunotherapy has been predicted from body and blood radiation doses to marrow. However, marrow radiation can be increased substantially if the marrow or skeleton contains the malignancy targeted by the radiolabeled monoclonal antibodies. A study of 29 patients treated with iodine-131 (131I)-Lym-1 showed that radiation doses to marrow from body and blood had little correlation with myelotoxicity. The purpose of the present study was to assess the significance of marrow targeting and other factors for prediction of myelotoxicity. METHODS. Injected radioactivity and nontargeted radiation doses to marrow were compared with peripheral blood cell counts after the first therapy dose of 131I-Lym-1 in 16 heavily pretreated patients with non-Hodgkin's lymphoma (NHL). Bone marrow biopsy, targeted marrow radiation doses, marrow image uptake scores, age, Karnofsky performance score (KPS), previous chemotherapy, and tumor burden were also compared with blood counts. RESULTS. Myelotoxicity was not predicted well by injected radioactivity, total body radiation, or body and blood radiation doses contributed to marrow (P > 0.1). Biopsy-proven bone marrow lymphoma also failed to predict myelotoxicity (P > 0.1). Thrombocytopenia and leukopenia were predicted well by targeted radiation dose to marrow (P < 0.05) obtained by 131I imaging. Similarly, marrow image scores predicted decreases in platelets and white blood cells (WBCs; P < 0.05). Prediction of myelotoxicity using marrow radiation dose methods was slightly improved when serum lactic dehydrogenase (LDH), age, KPS, and prior chemotherapy were included in the analysis (P ≤ 0.01). CONCLUSIONS. Prediction of myelotoxicity was improved in this group of patients by assessment of the targeting component of marrow radiation and was better predicted and obtained more easily by semiquantitative marrow image scores. Further improvement in prediction was slight when other factors were considered.

Original languageEnglish (US)
Pages (from-to)2558-2566
Number of pages9
JournalCancer
Volume80
Issue number12 SUPPL.
StatePublished - Dec 15 1997

Fingerprint

Radioimmunotherapy
Bone Marrow
Radiation
Radioactivity
Biopsy
Drug Therapy
Blood Cell Count
Leukopenia

Keywords

  • Dosimetry
  • Imaging
  • Lymphoma
  • Myelotoxicity
  • Radioimmunotherapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

DeNardo, D. A., Denardo, G. L., O'Donnell, R. T., Lim, S. M., Shen, S., Yuan, A., & DeNardo, S. J. (1997). Imaging for improved prediction of myelotoxicity after radioimmunotherapy. Cancer, 80(12 SUPPL.), 2558-2566.

Imaging for improved prediction of myelotoxicity after radioimmunotherapy. / DeNardo, Diane A.; Denardo, Gerald L; O'Donnell, Robert T; Lim, Sang Moo; Shen, Sui; Yuan, Aina; DeNardo, Sally J.

In: Cancer, Vol. 80, No. 12 SUPPL., 15.12.1997, p. 2558-2566.

Research output: Contribution to journalArticle

DeNardo, DA, Denardo, GL, O'Donnell, RT, Lim, SM, Shen, S, Yuan, A & DeNardo, SJ 1997, 'Imaging for improved prediction of myelotoxicity after radioimmunotherapy', Cancer, vol. 80, no. 12 SUPPL., pp. 2558-2566.
DeNardo DA, Denardo GL, O'Donnell RT, Lim SM, Shen S, Yuan A et al. Imaging for improved prediction of myelotoxicity after radioimmunotherapy. Cancer. 1997 Dec 15;80(12 SUPPL.):2558-2566.
DeNardo, Diane A. ; Denardo, Gerald L ; O'Donnell, Robert T ; Lim, Sang Moo ; Shen, Sui ; Yuan, Aina ; DeNardo, Sally J. / Imaging for improved prediction of myelotoxicity after radioimmunotherapy. In: Cancer. 1997 ; Vol. 80, No. 12 SUPPL. pp. 2558-2566.
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abstract = "BACKGROUND. The severity of myelotoxicity after radioimmunotherapy has been predicted from body and blood radiation doses to marrow. However, marrow radiation can be increased substantially if the marrow or skeleton contains the malignancy targeted by the radiolabeled monoclonal antibodies. A study of 29 patients treated with iodine-131 (131I)-Lym-1 showed that radiation doses to marrow from body and blood had little correlation with myelotoxicity. The purpose of the present study was to assess the significance of marrow targeting and other factors for prediction of myelotoxicity. METHODS. Injected radioactivity and nontargeted radiation doses to marrow were compared with peripheral blood cell counts after the first therapy dose of 131I-Lym-1 in 16 heavily pretreated patients with non-Hodgkin's lymphoma (NHL). Bone marrow biopsy, targeted marrow radiation doses, marrow image uptake scores, age, Karnofsky performance score (KPS), previous chemotherapy, and tumor burden were also compared with blood counts. RESULTS. Myelotoxicity was not predicted well by injected radioactivity, total body radiation, or body and blood radiation doses contributed to marrow (P > 0.1). Biopsy-proven bone marrow lymphoma also failed to predict myelotoxicity (P > 0.1). Thrombocytopenia and leukopenia were predicted well by targeted radiation dose to marrow (P < 0.05) obtained by 131I imaging. Similarly, marrow image scores predicted decreases in platelets and white blood cells (WBCs; P < 0.05). Prediction of myelotoxicity using marrow radiation dose methods was slightly improved when serum lactic dehydrogenase (LDH), age, KPS, and prior chemotherapy were included in the analysis (P ≤ 0.01). CONCLUSIONS. Prediction of myelotoxicity was improved in this group of patients by assessment of the targeting component of marrow radiation and was better predicted and obtained more easily by semiquantitative marrow image scores. Further improvement in prediction was slight when other factors were considered.",
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T1 - Imaging for improved prediction of myelotoxicity after radioimmunotherapy

AU - DeNardo, Diane A.

AU - Denardo, Gerald L

AU - O'Donnell, Robert T

AU - Lim, Sang Moo

AU - Shen, Sui

AU - Yuan, Aina

AU - DeNardo, Sally J.

PY - 1997/12/15

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N2 - BACKGROUND. The severity of myelotoxicity after radioimmunotherapy has been predicted from body and blood radiation doses to marrow. However, marrow radiation can be increased substantially if the marrow or skeleton contains the malignancy targeted by the radiolabeled monoclonal antibodies. A study of 29 patients treated with iodine-131 (131I)-Lym-1 showed that radiation doses to marrow from body and blood had little correlation with myelotoxicity. The purpose of the present study was to assess the significance of marrow targeting and other factors for prediction of myelotoxicity. METHODS. Injected radioactivity and nontargeted radiation doses to marrow were compared with peripheral blood cell counts after the first therapy dose of 131I-Lym-1 in 16 heavily pretreated patients with non-Hodgkin's lymphoma (NHL). Bone marrow biopsy, targeted marrow radiation doses, marrow image uptake scores, age, Karnofsky performance score (KPS), previous chemotherapy, and tumor burden were also compared with blood counts. RESULTS. Myelotoxicity was not predicted well by injected radioactivity, total body radiation, or body and blood radiation doses contributed to marrow (P > 0.1). Biopsy-proven bone marrow lymphoma also failed to predict myelotoxicity (P > 0.1). Thrombocytopenia and leukopenia were predicted well by targeted radiation dose to marrow (P < 0.05) obtained by 131I imaging. Similarly, marrow image scores predicted decreases in platelets and white blood cells (WBCs; P < 0.05). Prediction of myelotoxicity using marrow radiation dose methods was slightly improved when serum lactic dehydrogenase (LDH), age, KPS, and prior chemotherapy were included in the analysis (P ≤ 0.01). CONCLUSIONS. Prediction of myelotoxicity was improved in this group of patients by assessment of the targeting component of marrow radiation and was better predicted and obtained more easily by semiquantitative marrow image scores. Further improvement in prediction was slight when other factors were considered.

AB - BACKGROUND. The severity of myelotoxicity after radioimmunotherapy has been predicted from body and blood radiation doses to marrow. However, marrow radiation can be increased substantially if the marrow or skeleton contains the malignancy targeted by the radiolabeled monoclonal antibodies. A study of 29 patients treated with iodine-131 (131I)-Lym-1 showed that radiation doses to marrow from body and blood had little correlation with myelotoxicity. The purpose of the present study was to assess the significance of marrow targeting and other factors for prediction of myelotoxicity. METHODS. Injected radioactivity and nontargeted radiation doses to marrow were compared with peripheral blood cell counts after the first therapy dose of 131I-Lym-1 in 16 heavily pretreated patients with non-Hodgkin's lymphoma (NHL). Bone marrow biopsy, targeted marrow radiation doses, marrow image uptake scores, age, Karnofsky performance score (KPS), previous chemotherapy, and tumor burden were also compared with blood counts. RESULTS. Myelotoxicity was not predicted well by injected radioactivity, total body radiation, or body and blood radiation doses contributed to marrow (P > 0.1). Biopsy-proven bone marrow lymphoma also failed to predict myelotoxicity (P > 0.1). Thrombocytopenia and leukopenia were predicted well by targeted radiation dose to marrow (P < 0.05) obtained by 131I imaging. Similarly, marrow image scores predicted decreases in platelets and white blood cells (WBCs; P < 0.05). Prediction of myelotoxicity using marrow radiation dose methods was slightly improved when serum lactic dehydrogenase (LDH), age, KPS, and prior chemotherapy were included in the analysis (P ≤ 0.01). CONCLUSIONS. Prediction of myelotoxicity was improved in this group of patients by assessment of the targeting component of marrow radiation and was better predicted and obtained more easily by semiquantitative marrow image scores. Further improvement in prediction was slight when other factors were considered.

KW - Dosimetry

KW - Imaging

KW - Lymphoma

KW - Myelotoxicity

KW - Radioimmunotherapy

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