Platelet function after single [153Sm]EDTMP therapy in prostate cancer
Aim:
Aim of the study was to assess whether [153Sm] EDTMP therapy at a low-dose is associated with platelet activation.
Methods:
In 29 patients suffering from metastatic prostate cancer platelet count and various platelet function parameters have been monitored for 2 months after a single (the first) application of 1.1 GBq mCi [153Sm]EDTMP.
Results:
After 3 days insignificant signs of platelet activation (increase in malondialdehyde, adenosine diphosphate-induced platelet aggregation, decreased platelet sensitivity) occur, normalizing rapidly. At the nadir of platelet count (3-4 weeks) platelet aggregation response in non-count adjusted samples is somewhat lower, while activity per cell (count adjusted samples) is unchanged. Platelet proteins do not change at all. Insignificant activation of platelet function at day 3 is interpreted as an indicator of mild oxidation injury, late aggregation response changes in non-adjusted samples seem only to reflect temporarily decreased number of circulating platelets. Samarium-153-EDTMP therapy at doses (1.1 GBq) used in the Vienna-protocol is not associated with a significantly altered functional behavior of platelets.
Conclusions:
We conclude that a single dose of 1.1 GBq 153Sm-EDTMP does not significantly affect in vivo and ex vivo platelet function.
Insights
Low-dose [153Sm] EDTMP therapy for metastatic prostate cancer showed no significant platelet activation. This bone-seeking radiopharmaceutical is safe regarding platelet function, even at therapeutic doses.
Area of Science:
- Nuclear medicine
- Oncology
- Hematology
Background:
- Metastatic prostate cancer often requires palliative treatment.
- [153Sm] EDTMP is a bone-seeking radiopharmaceutical used for pain palliation.
- Potential effects of radiopharmaceuticals on platelet function require investigation.
Purpose of the Study:
- To evaluate the association between low-dose [153Sm] EDTMP therapy and platelet activation.
- To assess the safety of [153Sm] EDTMP in patients with metastatic prostate cancer regarding hematological parameters.
Main Methods:
- A single dose of 1.1 GBq [153Sm] EDTMP was administered to 29 patients with metastatic prostate cancer.
- Platelet count and function parameters were monitored for 2 months post-administration.
- Parameters included malondialdehyde levels, adenosine diphosphate-induced platelet aggregation, and platelet sensitivity.
Main Results:
- Transient, insignificant signs of platelet activation were observed 3 days post-therapy, rapidly normalizing.
- Platelet aggregation response was temporarily reduced in non-count adjusted samples at nadir platelet count, but activity per cell remained unchanged.
- No alterations in platelet proteins were detected, indicating no significant functional impact.
Conclusions:
- A single dose of 1.1 GBq [153Sm] EDTMP does not significantly affect in vivo and ex vivo platelet function.
- The observed mild platelet activation is likely due to transient oxidative stress and the temporary decrease in platelet count.
- [153Sm] EDTMP therapy at the studied dose is considered safe concerning platelet behavior.
