Korean J Lab Med.  2008 Dec;28(6):425-429. 10.3343/kjlm.2008.28.6.425.

Four Cases of Hematologic Malignancy Following Radioactive Iodine Therapy for Thyroid Cancer

• Im M
• Lee JK
• Hong YJ
• Hong SI
• Kang HJ
• Na II
• Ryoo BY
• Cheon GJ
• Lee HN
• Chang YH

• KMID: 1781576
• DOI: http://doi.org/10.3343/kjlm.2008.28.6.425

Abstract

Ionizing radiation including I131 might produce chromosomal translocation, causing hematologic malignancy. The incidence of leukemia following radioactive iodine treatment for thyroid cancer has been reported to be approximately 0.1 to 2.0% in Western countries, whereas fewer cases have been reported in Korea. We hereby report four cases of secondary hematologic malignancy, who received iodine therapy for thyroid cancer after thyroidectomy: two cases of acute lymphoblastic leukemia with t(9;22)(q34;q11.2), a case of MDS with 5q deletion, and a case of MDS with normal karyotype. Three cases of hematologic malignancy have developed after cumulative dosage of less than 800 mCi. The treatment intervals in two cases were less than 12 months, and the other two cases had I131 therapy only once. Assessment of causality using the Naranjo probability scale for adverse drug reactions showed that a 'possible' relationship existed between the use of I131 and secondary hematologic malignancy in all of the four cases in this report.

Keyword

Thyroid cancer; Radioisotope therapy

MeSH Terms

Adult
Chromosomes, Human, Pair 22
Chromosomes, Human, Pair 5
Chromosomes, Human, Pair 9
Female
Gene Deletion
Hematologic Neoplasms/*diagnosis/genetics
Humans
Iodine Radioisotopes/*adverse effects/therapeutic use
Leukemia, Radiation-Induced/*diagnosis/etiology
Middle Aged
Myelodysplastic Syndromes/diagnosis/genetics
Neoplasms, Second Primary/*diagnosis/genetics
Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis/genetics
Thyroid Neoplasms/*radiotherapy
Thyroidectomy
Translocation, Genetic

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