Spontaneous hematologic recovery from bone marrow aplasia after accidental
tenfold overdosage with radiophosphorus
J Gmur, B Bischof, S Coninx, U Bucher, G Poretti, K Henrichs, A Kaul, HD Roedler, K Buttner and PG Frick
Two patients with polycythemia vera received intravenously an accidental
tenfold overdosage of radiophosphorus therapy (60 and 50 mCi 32P,
respectively). In both patients, the occurrence of hemorrhagic
complications 3 wk after the 32P medication led to detection of the error
and referral to our hospital. Upon admission they showed an
agranulocytosis, severe thrombocytopenia, and bone marrow aplasia. In both
cases, spontaneous recovery of the hematopoiesis was observed from day 40
posttreatment onward. In one patient, a slow but ultimately complete
normalization of blood counts and marrow morphology took place, whereas in
the other, a mild thrombocytopenia persists. Nearly 5 yr after the
accidental overdosage, both patients are clinically well. Symptoms of
polycythemia vera have not reappeared up to now. Attempts were made to
evaluate the radiation dose absorbed by the bone marrow. In the first
patient, the daily 32P excretion was determined from day 22 to day 60,
whereas in the other patient a whole body count was performed on day 78
after administration. From these results, an approximate cumulative bone
marrow dose of 10 Sv (1000 rem) could be calculated.
Volume 61,
Issue 4,
pp. 746-750,
04/01/1983
Copyright © 1983 by The American Society of Hematology
