Prediction of myelotoxicity using radiation doses to marrow from body, blood and marrow sources

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

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Bone marrow is generally the dose-limiting organ in radioimmunotherapy (FLIT). Although radiation doses to marrow estimated from tracer doses have been shown to be comparable to those from therapy doses of radionuclide, the correlation of marrow radiation dose and myelotoxicity has not been well documented. The purpose of this study was to evaluate the relationship between radiation dose to marrow and subsequent changes in peripheral blood cell counts. Methods: Radiation doses to marrow from three sources, body, blood and marrow targeting, were compared with changes in blood counts after the first therapy dose of 131I-Lym-1 in 16 patients. Doses of 131I- Lym-1 ranged from 1.1-8.2 GBq (29-222 mCi). Cumulated radioactivity in the body and marrow were obtained using sequential, quantitative images of the body end lumbar vertebrae, respectively, and that in blood using activity in blood samples. The individual and sum of radiation doses from penetrating radiations in the body, and nonpenetrating radiations in the blood and marrow, were compared with blood counts. Results: In this group of patients, median radiation doses were 15.1, 15.4 and 42.1 cGy from body, blood and marrow targeting, respectively. Linear regression of radiation doses from body and blood versus fractional decreases in blood counts produced correlation coefficients of 0.38, 0.06, 0.22 and less than 0.01 for platelets, granulocytes, white blood cells (WBCs) end hematocrit, respectively. Linear regression of targeted marrow radiation doses versus fractional decreases in blood counts produced correlation coefficients 0.61, 0,31, 0.54 and 0.20 for platelets, granulocytes, WBCs and hematocrit. The closest association was found between radiation dose to marrow from marrow targeting and change in platelet count (r = 0.61). Conclusion: In patients, such as those with non-Hodgkin's lymphoma (NHL), likely to have marrow targeting, prediction of myelotoxicity by conventional body and blood contributions to marrow is substantially improved by the use of radiation dose to marrow estimated from images.

Original languageEnglish (US)
Pages (from-to)1374-1378
Number of pages5
JournalJournal of Nuclear Medicine
Volume38
Issue number9
StatePublished - Sep 1997

Fingerprint

Bone Marrow
Radiation
Hematocrit
Granulocytes
Linear Models
Leukocytes
Blood Platelets
Radioimmunotherapy
Lumbar Vertebrae
Blood Cell Count
Body Image
Platelet Count
Radioisotopes
Non-Hodgkin's Lymphoma
Radioactivity

Keywords

  • Dosimetry
  • Iodine-131-Lym-1
  • Myelotoxicity
  • Radioimmunotherapy

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Prediction of myelotoxicity using radiation doses to marrow from body, blood and marrow sources. / Lim, Sang Moo; Denardo, Gerald L; DeNardo, Diane A.; Shen, Sui; Yuan, Aina; O'Donnell, Robert T; DeNardo, Sally J.

In: Journal of Nuclear Medicine, Vol. 38, No. 9, 09.1997, p. 1374-1378.

Research output: Contribution to journalArticle

Lim, Sang Moo ; Denardo, Gerald L ; DeNardo, Diane A. ; Shen, Sui ; Yuan, Aina ; O'Donnell, Robert T ; DeNardo, Sally J. / Prediction of myelotoxicity using radiation doses to marrow from body, blood and marrow sources. In: Journal of Nuclear Medicine. 1997 ; Vol. 38, No. 9. pp. 1374-1378.
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abstract = "Bone marrow is generally the dose-limiting organ in radioimmunotherapy (FLIT). Although radiation doses to marrow estimated from tracer doses have been shown to be comparable to those from therapy doses of radionuclide, the correlation of marrow radiation dose and myelotoxicity has not been well documented. The purpose of this study was to evaluate the relationship between radiation dose to marrow and subsequent changes in peripheral blood cell counts. Methods: Radiation doses to marrow from three sources, body, blood and marrow targeting, were compared with changes in blood counts after the first therapy dose of 131I-Lym-1 in 16 patients. Doses of 131I- Lym-1 ranged from 1.1-8.2 GBq (29-222 mCi). Cumulated radioactivity in the body and marrow were obtained using sequential, quantitative images of the body end lumbar vertebrae, respectively, and that in blood using activity in blood samples. The individual and sum of radiation doses from penetrating radiations in the body, and nonpenetrating radiations in the blood and marrow, were compared with blood counts. Results: In this group of patients, median radiation doses were 15.1, 15.4 and 42.1 cGy from body, blood and marrow targeting, respectively. Linear regression of radiation doses from body and blood versus fractional decreases in blood counts produced correlation coefficients of 0.38, 0.06, 0.22 and less than 0.01 for platelets, granulocytes, white blood cells (WBCs) end hematocrit, respectively. Linear regression of targeted marrow radiation doses versus fractional decreases in blood counts produced correlation coefficients 0.61, 0,31, 0.54 and 0.20 for platelets, granulocytes, WBCs and hematocrit. The closest association was found between radiation dose to marrow from marrow targeting and change in platelet count (r = 0.61). Conclusion: In patients, such as those with non-Hodgkin's lymphoma (NHL), likely to have marrow targeting, prediction of myelotoxicity by conventional body and blood contributions to marrow is substantially improved by the use of radiation dose to marrow estimated from images.",
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T1 - Prediction of myelotoxicity using radiation doses to marrow from body, blood and marrow sources

AU - Lim, Sang Moo

AU - Denardo, Gerald L

AU - DeNardo, Diane A.

AU - Shen, Sui

AU - Yuan, Aina

AU - O'Donnell, Robert T

AU - DeNardo, Sally J.

PY - 1997/9

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N2 - Bone marrow is generally the dose-limiting organ in radioimmunotherapy (FLIT). Although radiation doses to marrow estimated from tracer doses have been shown to be comparable to those from therapy doses of radionuclide, the correlation of marrow radiation dose and myelotoxicity has not been well documented. The purpose of this study was to evaluate the relationship between radiation dose to marrow and subsequent changes in peripheral blood cell counts. Methods: Radiation doses to marrow from three sources, body, blood and marrow targeting, were compared with changes in blood counts after the first therapy dose of 131I-Lym-1 in 16 patients. Doses of 131I- Lym-1 ranged from 1.1-8.2 GBq (29-222 mCi). Cumulated radioactivity in the body and marrow were obtained using sequential, quantitative images of the body end lumbar vertebrae, respectively, and that in blood using activity in blood samples. The individual and sum of radiation doses from penetrating radiations in the body, and nonpenetrating radiations in the blood and marrow, were compared with blood counts. Results: In this group of patients, median radiation doses were 15.1, 15.4 and 42.1 cGy from body, blood and marrow targeting, respectively. Linear regression of radiation doses from body and blood versus fractional decreases in blood counts produced correlation coefficients of 0.38, 0.06, 0.22 and less than 0.01 for platelets, granulocytes, white blood cells (WBCs) end hematocrit, respectively. Linear regression of targeted marrow radiation doses versus fractional decreases in blood counts produced correlation coefficients 0.61, 0,31, 0.54 and 0.20 for platelets, granulocytes, WBCs and hematocrit. The closest association was found between radiation dose to marrow from marrow targeting and change in platelet count (r = 0.61). Conclusion: In patients, such as those with non-Hodgkin's lymphoma (NHL), likely to have marrow targeting, prediction of myelotoxicity by conventional body and blood contributions to marrow is substantially improved by the use of radiation dose to marrow estimated from images.

AB - Bone marrow is generally the dose-limiting organ in radioimmunotherapy (FLIT). Although radiation doses to marrow estimated from tracer doses have been shown to be comparable to those from therapy doses of radionuclide, the correlation of marrow radiation dose and myelotoxicity has not been well documented. The purpose of this study was to evaluate the relationship between radiation dose to marrow and subsequent changes in peripheral blood cell counts. Methods: Radiation doses to marrow from three sources, body, blood and marrow targeting, were compared with changes in blood counts after the first therapy dose of 131I-Lym-1 in 16 patients. Doses of 131I- Lym-1 ranged from 1.1-8.2 GBq (29-222 mCi). Cumulated radioactivity in the body and marrow were obtained using sequential, quantitative images of the body end lumbar vertebrae, respectively, and that in blood using activity in blood samples. The individual and sum of radiation doses from penetrating radiations in the body, and nonpenetrating radiations in the blood and marrow, were compared with blood counts. Results: In this group of patients, median radiation doses were 15.1, 15.4 and 42.1 cGy from body, blood and marrow targeting, respectively. Linear regression of radiation doses from body and blood versus fractional decreases in blood counts produced correlation coefficients of 0.38, 0.06, 0.22 and less than 0.01 for platelets, granulocytes, white blood cells (WBCs) end hematocrit, respectively. Linear regression of targeted marrow radiation doses versus fractional decreases in blood counts produced correlation coefficients 0.61, 0,31, 0.54 and 0.20 for platelets, granulocytes, WBCs and hematocrit. The closest association was found between radiation dose to marrow from marrow targeting and change in platelet count (r = 0.61). Conclusion: In patients, such as those with non-Hodgkin's lymphoma (NHL), likely to have marrow targeting, prediction of myelotoxicity by conventional body and blood contributions to marrow is substantially improved by the use of radiation dose to marrow estimated from images.

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