Secondary myelodysplastic syndrome and leukemia following 131I-metaiodobenzylguanidine therapy for relapsed neuroblastoma.
OBJECTIVE
To describe three patients with secondary leukemia after treatment with 131I-metaiodobenzylguanidine (MIBG) for neuroblastoma.


METHODS
Of 95 children with refractory neuroblastoma treated with 131I-MIBG at UCSF, 3 have been identified with secondary myelodysplasia/leukemia. The case records and bone marrow results were reviewed, along with a review of the literature.


RESULTS
Three patients developed secondary myelodysplasia/leukemia, at 7, 11, and 12 months following 131I-MIBG therapy. Cytogenetic abnormalities included -7q/-5, -7/+2q37, -11 and +12. Three additional cases were found in literature review of 509 reported patients treated with 131I-MIBG for neuroblastoma.


CONCLUSIONS
Therapy with 131I-MIBG may contribute to the risk of secondary leukemia in patients who have received intensive chemotherapy, thought the risk of this complication is far lower than the risk of disease progression. Further monitoring for this complication is indicated.
Weiss
Brian
B
Department of Pediatrics, M647, University of California San Francisco, 505 Parnassus, San Francisco, CA 94143-0106, USA. matthayk@peds.ucsf.edu
Vora
Amish
A
Huberty
John
J
Hawkins
Randall A
RA
Matthay
Katherine K
KK
D019797:3-Iodobenzylguanidine / Q000009:adverse effects / Q000627:therapeutic use*; D001853:Bone Marrow / Q000473:pathology; D002648:Child; D002869:Chromosome Aberrations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007953:Leukemia, Radiation-Induced / Q000453:epidemiology*; D008297:Male; D009190:Myelodysplastic Syndromes / Q000000981:diagnostic imaging / Q000209:etiology*; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging / Q000209:etiology*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use; D012008:Recurrence; D013997:Time Factors
D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine