Persistent Hematologic Dysfunction after Peptide Receptor Radionuclide Therapy with 177Lu-DOTATATE: Incidence, Course, and Predicting Factors in Patients with Gastroenteropancreatic Neuroendocrine Tumors

• DOI: 10.2967/jnumed.117.189712
• Publication Date: 2017-08-04T00:50:21Z
• Authors: Hendrik Bergsma; Kirsten van Lom; Marc H.G.P. Raaij...; M. Konijnenberg; B.L. Boen L.R. Kam; Jaap J.M. Teunissen; Wouter W. de Herder; Eric P. Krenning; Dik J. Kwekkeboom
• Keywords: Radionuclide therapy; Cytopenia; Cumulative incidence

Peptide receptor radionuclide therapy (PRRT) may induce long-term toxicity to the bone marrow (BM). The aim of this study was analyze persistent hematologic dysfunction (PHD) after PRRT with ¹⁷⁷Lu-DOTATATE in patients gastroenteropancreatic neuroendocrine tumors (GEP NETs). <b>Methods:</b> incidence and course PHD were analyzed 274 GEP NET from a group 367 somatostatin receptor–positive tumors. defined as diagnosis myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), myeloproliferative neoplasm (MPN), MDS/MPN, or otherwise unexplained cytopenia (for &gt;6 mo). Using data Netherlands Cancer Registry, expected number hematopoietic neoplasms (MDS, AML, MPN, MDS/MPN) calculated adjusted for sex, age, follow-up period. following risk factors assessed: age over 70 y, metastasis, prior chemotherapy, external-beam radiotherapy, uptake on [¹¹¹In-DTPA⁰]octreotide scan, tumor load, grade 3–4 during treatment, estimated absorbed BM dose, elevated plasma chromogranin A level, baseline blood counts, renal function. <b>Results:</b> Eleven (4%) had treatment ¹⁷⁷Lu-DOTATATE: 8 (2.9%) developed (4 MDS, 1 2 3 (1.1%) failure characterized by aplasia. median latency period at (or first suspicion PHD) 41 mo (range, 15–84 based Registry 3.0, resulting relative 2.7 (95% confidence interval, 0.7–10.0). No could be identified patients, not even metastasis dose. Seven anemia combination rise mean corpuscular volume. <b>Conclusion:</b> prevalence 4% our patient population. time which cycle. developing 2.7. found development patients.