Research Papers:

Analysis of hematological parameters as prognostic markers for toxicity and survival of 223Radium treatment

Asha Leisser, Marzieh Nejabat, Markus Hartenbach, Reza Agha Mohammadi Sareshgi, Shahrokh Shariat, Gero Kramer, Michael Krainer, Marcus Hacker and Alexander R. Haug _

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Oncotarget. 2018; 9:16197-16204. https://doi.org/10.18632/oncotarget.24610

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Asha Leisser1, Marzieh Nejabat1, Markus Hartenbach1, Reza Agha Mohammadi Sareshgi1,4, Shahrokh Shariat2, Gero Kramer2, Michael Krainer3, Marcus Hacker1 and Alexander R. Haug1

1Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria

2Department of Urology, Medical University of Vienna, Vienna, Austria

3Department of Oncology, Medical University of Vienna, Vienna, Austria

4FH Campus Wien, University of Applied Sciences, Department of Radiotechnology, Vienna, Austria

Correspondence to:

Alexander R. Haug, email: [email protected]

Keywords: 223Radium; hematotoxicity; radio-nuclide therapy; metastatic CRPC; adverse event

Received: January 19, 2018     Accepted: February 25, 2018     Epub: March 05, 2018      Published: March 23, 2018


223Radium (223Ra) has emerged as treatment prolonging survival in patients with metastatic castration-resistant prostate cancer (CRPC). As 223Ra can cause hematotoxicity (HT), pre-existing hematopoiesis might influence the efficacy of 223Ra and the rate of hematotoxicity, but as to our knowledge such data has not been published yet, we retrospectively conducted an analysis on patients receiving 223Ra.

54 patients treated with 223Ra had a median survival of 67 weeks, which was significantly reduced in patients with pre-existing Hb toxicity (Tox) grade 2 (48 weeks P = 0.008) as compared to grade 1 (67 weeks) and normal levels of Hb (not reached); survival in patients with Plt Tox grade 1 was significantly reduced (44 weeks) as compared to normal Plt counts (71 weeks, P = 0.033). Patients with impaired hematopoiesis regarding Hb and Plts developed significantly more grade 3 and 4 HT (Hb < 10 g/dl: 42.9% [3/7] vs 10.6% [5/47], P < 0.001; Plt < 150 G/L: 28.6% [2/7] vs 6.4% [3/47], P = 0.002) and received significantly fewer treatment cycles (Hb <10 g/dl: 5.1 vs 5.8, P = 0.04; Plt < 150 G/L: 3.4 vs 5.6, P < 0.001). These results imply that pre-existing impaired hematopoiesis, in particular thrombocytopenia and anemia, before 223Ra therapy, is an important risk factor for worse outcome of treatment with 223Ra.

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