Interference of patient medication in the radiolabelling of white blood cells: an update

Evidence is now accumulating that patient medication can adversely affect the radiolabelling of white cells. We have undertaken a survey for the years 1981-97 to examine instances of unusually low labelling efficiencies of 111In-tropolone and 99Tcm-HMPAO labelled white cells. Respondents were asked to ascertain which drugs were being taken on the day of the test. Fifty adverse reports were received during that period. Many patients were taking drugs which are known to affect white cell function, including cephalosporins, azathioprine, prednisolone, cyclophosphamide, nifedipine, suphasalazine, iron salts and heparin. Using Bradford-Hill's criteria to assess whether an association between two variables is also one of causation, it was found that there was a high probability that the above drugs caused the low labelling efficiencies.