Therapy‐related chronic myeloid leukemia in a patient receiving peptide receptor radionuclide therapy for pancreatic neuroendocrine tumor

Küçükyurt, Selin; Ozogul, Yeliz Yagiz; Erçalışkan, Abdülkadir; Kabasakal, Levent; Eşkazan, Ahmet Emre

doi:10.1002/cnr2.1282

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…The myeloid neoplasms reported in these patients were AML and myelodysplastic syndrome and were associated with a poor prognosis 29 . Therapy‐related CML is a rare entity and has previously been reported after Lu‐PRRT 30 . Despite the small number of our group, one patient developed AML and another developed CML after Lu‐PRRT and both were associated with poor prognosis.…”

Section: Discussion/conclusionmentioning

confidence: 65%

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Real‐world efficacy of lutetium peptide receptor radionuclide therapy in patients with neuroendocrine tumours

Almeamar

Cullen

Murphy

et al. 2022

J Neuroendocrinology

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Lutetium peptide receptor radio nuclide therapy (Lu-PRRT) is an effective treatment for progressive, metastatic, somatostatin-receptor-positive, well-differentiated neuroendocrine tumours (WD-NETs). Here, we report a single centre experience of real-world efficacy, long-term side effects, and challenges of this treatment. This was a retrospective analysis. All patients linked with our centre who had Lu-PRRT were included. Clinicopathological data were analysed using descriptive statistics, Kaplan-Meier, and Cox regression. A total of 45 patients had Lu-PRRT, of those 30 (67%) were males, and 13 (29%) were more than 65 years old. The primary site was small intestine in 30 (67%) patients, pancreas in seven (16%) patients, and lung in three (7%) patients. The tumor was grade 1 in 15 (35%) patients, grade 2 in 22 (48%) patients, and grade 3 in six (13%) patients. A total of 41 (91%) patients had liver metastasis, and 20 (44%) patients had carcinoid syndrome. Lu-PRRT was the secondline therapy in all patients. Krenning's score was 4 in 36 (80%) patients and 3 in nine (20%) patients. The median waiting time to start Lu-PRRT therapy was 87 days. The median follow-up was 41 months. A total of 23 (51%) patients had a partial response, 18 (40%) patients had stable disease, and four (9%) patients had progression. None of the patients had a complete response. The median progression-free survival (PFS) was 38 months (95% CI: 25.8-50.1). The median overall survival (OS) was not reached. Nine patients died during follow-up (death from any cause). Prior treatment with targeted therapies or high dose somatostatin analogues were negative predictors of Lu-PRRT outcome (p-values of < .001 and < .045, respectively). There were two serious haematological toxicities, one patient developed acute myeloid leukaemia (AML), and the other developed chronic myeloid leukaemia (CML).Lu-PRRT is an effective second-line treatment for metastatic WD-NETs. The effect of targeted therapies on Lu-PRRT outcome was significant and needs to be clarified in further studies.

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Section: Discussion/conclusionmentioning

confidence: 65%

“…29 Therapy-related CML is a rare entity and has previously been reported after Lu-PRRT. 30 Despite the small number of our group, one patient developed AML and another developed CML after Lu-PRRT and both were associated with poor prognosis.…”

Section: Discussion/conclusionmentioning

confidence: 72%

Real‐world efficacy of lutetium peptide receptor radionuclide therapy in patients with neuroendocrine tumours

Almeamar

Cullen

Murphy

et al. 2022

J Neuroendocrinology

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“…Lamentablemente, a los pocos meses de la estabilización del insulinoma maligno, la paciente fue diagnosticada de leucemia mieloide crónica (LMC) e ingresó en el hospital donde falleció tras múltiples complicaciones derivadas de su delicado estado físico. Aunque la LMC has sido descrita en casos anecdóticos tras tratamiento con PRRT, el escaso intervalo entre la terapia con PRRT y el desarrollo del LMC y la ausencia de tratamientos agentes alquilantes previos, no estarían a favor de esta hipótesis (12).…”

Section: Caso Clínicounclassified

Peptide receptor radionuclide therapy for malignant insulinoma: New horizons

2022

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Malignant insulinoma is a rare neuroendocrine tumor, located exclusively in the pancreas, characterized by severe hypoglycemia secondary to excessive insulin secretion. Somatostatin analogs (SSA) and everolimus have been added to the classic treatment with diazoxide in the last years. Peptide receptor radionuclide therapy (PRRT) has also been recently tested in a few patients with insulinoma with apparently satisfactory results. We present a 49-year-old woman with a loss of consciousness in the context of severe hypoglycemia that was diagnosed of malignant insulinoma. She underwent tumor excision and a total pancreatectomy and after an extended hospital stay, she was discharged without hypoglycemia under treatment with ASS. After observing tumor progression, treatment with 4 cycles of PRRT was performed with symptomatic control, reduction of some of the metastatic lesions and stabilization of other lesions with excellent tolerance to treatment. PRRT is a possible alternative for the symptomatic and etiological treatment of malignant insulinoma.

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Octreotide/sunitinib

2020

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Therapy‐related chronic myeloid leukemia in a patient receiving peptide receptor radionuclide therapy for pancreatic neuroendocrine tumor

Cited by 3 publications

References 16 publications

Real‐world efficacy of lutetium peptide receptor radionuclide therapy in patients with neuroendocrine tumours

Real‐world efficacy of lutetium peptide receptor radionuclide therapy in patients with neuroendocrine tumours

Peptide receptor radionuclide therapy for malignant insulinoma: New horizons

Octreotide/sunitinib

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