Chromosomal analysis of peripheral lymphocytes of patients before and after radiation synovectomy with samarium-153 particulate hydroxyapatite

• Published in: Rheumatology (Oxford, England) England), 1999-04, Vol.38 (4), p.316-320
• Main Authors: O'DUFFY, E. K, OLIVER, F. J, CHATTERS, S. J, WALKER, H, LLOYD, D. C, EDWARDS, J. C. W, ELL, P. J
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arthritis, Psoriatic - complications; Arthritis, Psoriatic - genetics; Arthritis, Psoriatic - radiotherapy; Biological and medical sciences; Chromatids; Chromosome Aberrations; Chromosomes - radiation effects; Diseases of the osteoarticular system. Orthopedic treatment; Double-Blind Method; Female; Humans; Hydroxyapatites - therapeutic use; Lymphocytes - radiation effects; Male; Medical sciences; Metaphase - genetics; Middle Aged; Quality Control; Radiopharmaceuticals - therapeutic use; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Samarium - therapeutic use; Synovial Membrane - cytology; Synovial Membrane - immunology; Synovitis - etiology; Synovitis - genetics; Synovitis - radiotherapy
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/38.4.316

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). There was no increase in scored chromosome-type abnormalities after Sm-153 PHYP synovectomy. This study further supports the relative safety of Sm-153 PHYP compared to other radiopharmaceuticals.