Chromosomal analysis of peripheral lymphocytes of patients before and after radiation synovectomy with samarium-153 particulate hydroxyapatite.
OBJECTIVE
Radiation synovectomy may be indicated for the treatment of chronic synovitis. A number of factors may affect its current use, including availability, limited evidence for its efficacy compared to intra-articular glucocorticoid, and concerns regarding the potential long-term effects of radiation exposure, particularly in younger patients. Specific chromosome-type abnormalities in peripheral lymphocytes can be useful indicators of whole-body radiation exposure. The frequency of these aberrations has been shown to increase in patients who have had radiation synovectomy using yttrium-90 by up to five times compared to baseline levels. Samarium-153 particulate hydroxyapatite (Sm-153 PHYP) is a new radiopharmaceutical currently on trial which appears to have less extra-articular leakage than yttrium-90 compounds. The aim of this study was to identify any increase in specific chromosome-type abnormalities, using published criteria, in patients following Sm-153 PHYP synovectomy of the knee. The 10 patients (five men, five women) in whom the analyses were performed had a mean age of 47 yr (range 28-70 yr).


RESULTS
There was no increase in scored chromosome-type abnormalities after Sm-153 PHYP synovectomy.


CONCLUSIONS
This study further supports the relative safety of Sm-153 PHYP compared to other radiopharmaceuticals.
O'Duffy
E K
EK
Institute of Nuclear Medicine, University College London, UK.
Oliver
F J
FJ
Chatters
S J
SJ
Walker
H
H
Lloyd
D C
DC
Edwards
J C
JC
Ell
P J
PJ
D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000150:complications / Q000235:genetics / Q000532:radiotherapy; D002842:Chromatids; D002869:Chromosome Aberrations; D002875:Chromosomes / Q000528:radiation effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006882:Hydroxyapatites / Q000627:therapeutic use*; D008214:Lymphocytes / Q000528:radiation effects*; D008297:Male; D008677:Metaphase / Q000235:genetics; D008875:Middle Aged; D011786:Quality Control; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D012493:Samarium / Q000627:therapeutic use*; D013583:Synovial Membrane / Q000166:cytology / Q000276:immunology; D013585:Synovitis / Q000209:etiology / Q000235:genetics* / Q000532:radiotherapy*
D006882:Hydroxyapatites; D019275:Radiopharmaceuticals; C091049:samarium hydroxyapatite; D012493:Samarium