Pre-therapeutic blood dosimetry in patients with differentiated thyroid carcinoma using 124-iodine: predicted blood doses correlate with changes in blood cell counts after radioiodine therapy and depend on modes of TSH stimulation and number of preceding radioiodine therapies

Our aim was to test the efficacy of 131-I therapy (RIT) using recombinant human TSH (rhTSH) in patients with differentiated thyroid carcinoma (DTC) in whom endogenous TSH stimulation was not an option due to the poor patient's physical condition or due to the disease progression during L-thyroxin withdrawal. The study comprised 18 patients, who already have undergone total or near-total thyroidectomy and radioiodine ablation and 0–12 (median 5) RITs after L-thyroxin withdrawal. Our patients received altogether 44 RITs using rhTSH while on L-thyroxin. Six to 12 months after the first rhTSH-aided RIT, PR and SD was achieved in 3/18 (17%) and 4/18 patients (22%), respectively. In most patients (n= 12; 61%) disease progressed despite rhTSH-aided RITs. As a conclusion, rhTSH-aided RIT proved to add some therapeutic benefit in 39% our patients with metastatic DTC, who otherwise could not be efficiently treated with RIT.

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Effect of radioiodine therapy (131I) on blood cells of differentiated thyroid carcinoma patients

Vietnam Journal of Biotechnology ◽

10.15625/1811-4989/14453 ◽

2021 ◽

Vol 19 (3) ◽

pp. 449-457

Author(s):

Nguyen Thi Giang An ◽

Nguyen Quang Trung

Keyword(s):

Thyroid Carcinoma ◽

Blood Cell ◽

Blood Cells ◽

Research Result ◽

White Blood Cells ◽

Thyroid Tissue ◽

Differentiated Thyroid Carcinoma ◽

Reference Level ◽

High Dose ◽

Cell Counts

Thyroid cancer accounts for about 1% of all types of cancers, with about 80% of cases being differentiated and 20% undifferentiated. Our study was conducted on 209 Differentiated Thyroid Carcinoma (DTC) patients treated at the Department of Nuclear Medicine of Nghe An Cancer Hospital with 91.39% of patients having papillary thyroid carcinoma, with the mean age of 47.91 ± 12.08. The geographic distribution of these patients was determined to be 68.42% coastal plains. Patients living in mountainous areas accounted for only 6.22%. For our experiment, treatment for patients including having the tumor removed and thyroid tissue destroyed using 131I. Patients were then prescribed with alternative hormones varying at different doses depending on the degree and stage of cancer. Among 209 patients, 8 patients were treated with 30mCi dose(3.83%); 196 patients treated with the dose of 100–150 mCi (93.78%) and 5 patients treated 200–250 mCi (2.39%). After 3–5 days of treatment, we observed significant changes in blood count with p<0.05. Initially, erythrocytes and hemoglobin count decreased slightly for 30–150 mCi dose patients but with 200–250 mCi dose patients, those indexes fell below the reference level. The platelet index decreased significantly after 3–5 days of treatment (p<0.05). Total leukocytes, lymphocytes and mono count decreased sharply after treatment (p<0.05) but neutrophils changed very little. After 3–6 months of treatment, the blood cell formula gradually stabilized, the recovery of red blood cells took place faster than the white blood cells and platelets. The recovery of blood cells of patients treated with doses of 200–500 mCi took place more slowly (p<0.05). Thus, the use of 131I in the treatment of DTC is a common and effective method, but they may also be at risk of impairing blood cells, especially in high-dose 131I patients. However, this change is still within the allowable limits and after 6 months of treatment, the blood cell counts tend to return to their original values. The speed of recovery depends on the individual blood cell line and the amount of treatment. This research result can be used as a reference for deciding on 131I dosage and supportive measures, interventions in treatment, helping patients avoiding the decrease of blood cells and increase the effectiveness of the treatment process.

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An Alternative Elastase-mediated Degradation of Fibrinogen and Fibrin Observed in a Patient with Herpes Simplex Encephalitis and Pneumonia

Thrombosis and Haemostasis ◽

10.1055/s-0038-1650550 ◽

1996 ◽

Vol 76 (02) ◽

pp. 184-186 ◽

Cited By ~ 2

Author(s):

Kenji lijima ◽

Fumiyo Murakami ◽

Yasushi Horie ◽

Katsumi Nakamura ◽

Shiro Ikawa ◽

...

Keyword(s):

Herpes Simplex ◽

Blood Cell ◽

White Blood Cell ◽

Herpes Simplex Encephalitis ◽

Pmn Elastase ◽

Cell Counts ◽

Blood Cell Counts ◽

Sds Page ◽

White Blood Cell Counts ◽

Pmn Élastase

SummaryA 74-year-old female developed pneumonia following herpes simplex encephalitis. Her white blood cell counts reached 28,400/μl, about 90% of which consisted of granulocytes. The polymorphonuclear (PMN) elastase/α1-arantitrypsin complex levels increased and reached the maximum of 5,019 ng/ml, indicating the release of a large amount of elastase derived from the granulocytes. The mechanism of PMN elastase release was most likely to be granulocyte destruction associated with phagocytosis. The cleavage of fibrinogen and fibrin by PMN elastase, independent of plasmin, was indicated by the presence of the fragments in immunoprecipitated plasma from the patient corresponding to elastase-induced FDP D and DD fragments and the absence of fragments corresponding to plasmin-induced FDP D and DD fragments on SDS-PAGE. These findings suggested that the large amount of PMN elastase released from the excessive numbers of granulocytes in this patient with herpes simplex encephalitis and pneumonia, induced the cleavage of fibrinogen and fibrin without the participation of plasmin.

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