Leukemia after a small dose of radioiodine for metastatic thyroid cancer

Acute Myeloid Leukemia after Low-Dose Radioiodine Therapy for Papillary Thyroid Carcinoma

Papillary thyroid carcinoma is the most common primary thyroid cancer. Most frequently treated with surgical resection, some cases require radioactive iodine (RAI) therapy. Studies have suggested that there is an increase in second primary malignancy after RAI therapy amongst thyroid cancer survivors including acute myeloid leukemia (AML) as an infrequent cancer related to RAI therapy; it has a higher relative risk ratio in patients on higher doses of radiation exposure. We would like to report a 30-year-old lady who was diagnosed with papillary thyroid carcinoma. She underwent total thyroidectomy and received a low-dose RAI ¹³¹I therapy at a dose of 150 mCi, after which she developed therapy-related AML. Here we would like to highlight the association of AML with low-dose RAI as an infrequent cause of a second primary tumor compared to high doses.

Vaccinia virus GLV-1h153 in combination with 131I shows increased efficiency in treating triple-negative breast cancer

We investigated the therapeutic efficacy of a replication-competent oncolytic vaccinia virus, GLV-1h153, carrying human sodium iodide symporter (hNIS), in combination with radioiodine in an orthotopic triple-negative breast cancer (TNBC) murine model. In vitro viral infection was confirmed by immunoblotting and radioiodine uptake assays. Orthotopic xenografts (MDA-MB-231 cells) received intratumoral injection of GLV-1h153 or PBS. One week after viral injection, xenografts were randomized into 4 treatment groups: GLV-1h153 alone, GLV-1h153 and (131)I (∼ 5 mCi), (131)I alone, or PBS, and followed for tumor growth. Kruskal-Wallis and Wilcoxon tests were performed for statistical analysis. Radiouptake assay showed a 178-fold increase of radioiodine uptake in hNIS-expressing infected cells compared with PBS control. Systemic (131)I-iodide in combination with GLV-1h153 resulted in a 6-fold increase in tumor regression (24 compared to 146 mm(3) for the virus-only treatment group; P<0.05; d 40). We demonstrated that a novel vaccinia virus, GLV-1h153, expresses hNIS, increases the expression of the symporter in TNBC cells, and serves both as a gene marker for noninvasive imaging of virus and as a vehicle for targeted radionuclide therapy with (131)I.

Myeloid Sarcoma of the Uterine Cervix as Presentation of Acute Myeloid Leukaemia after Treatment with Low-Dose Radioiodine for Thyroid Cancer: A Case Report and Review of the Literature

The development of acute myeloid leukaemia after low-dose radioiodine therapy and its presentation as a myeloid sarcoma of the uterine cervix are both rare events. We report a case of acute myeloid leukaemia revealed by a myeloid sarcoma of the uterine cervix in a 48-year-old woman, 17 months after receiving a total dose of 100 mCi (131)I for papillary thyroid cancer. A strict hematological follow-up of patients treated with any dose of (131)I is recommended to accurately detect any hematological complications which might have been underestimated. Unusual presentations, such as chloroma of the uterine cervix, may reveal myeloid malignancy and should be kept in mind.