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Cancer Biotherapy & Radiopharmaceuticals
Effects of Radiosynovectomy with P-32 Colloid Therapy in Hemophilia and Rheumatoid Arthritis
To cite this article:
Victoria Ester Soroa, Mańa del Huerto Velázquez Espeche, Carlos Giannone, Horacio Caviglia, Gustavo Galatros, Daniel Fernández, Marcos Méndez, Gustavo Guillermo Naswetter, Jorge Osvaldo Nicolini.
Cancer Biotherapy & Radiopharmaceuticals.
June 2005,
20(3): 344-348.
doi:10.1089/cbr.2005.20.344.
Victoria Ester Soroa Centro de Medicina Nuclear, Comision Nacional de Energía Atómica Argentina, Buenos Aires, IAEA, Argentina. Rheumatology, Hospital De Clínicas "José de San Martin," Universidad de Buenos Aires, Buenos Aires, Argentina. Mańa del Huerto Velázquez Espeche Centro de Medicina Nuclear, Comision Nacional de Energía Atómica Argentina, Buenos Aires, IAEA, Argentina. Carlos Giannone Centro de Medicina Nuclear, Comision Nacional de Energía Atómica Argentina, Buenos Aires, IAEA, Argentina. Horacio Caviglia Traumatology and Orthopedics, Hospital Municipal, J. A. Fernández, Hemophilic Foundation, Buenos Aires, Argentina. Gustavo Galatros Traumatology and Orthopedics, Hospital Municipal, J. A. Fernández, Hemophilic Foundation, Buenos Aires, Argentina. Daniel Fernández Rheumatology, Hospital De Clínicas "José de San Martin," Universidad de Buenos Aires, Buenos Aires, Argentina. Marcos Méndez Rheumatology, Hospital De Clínicas "José de San Martin," Universidad de Buenos Aires, Buenos Aires, Argentina. Gustavo Guillermo Naswetter Rheumatology, Hospital De Clínicas "José de San Martin," Universidad de Buenos Aires, Buenos Aires, Argentina. Jorge Osvaldo Nicolini Radiopharmacy, Laboratory Bacon, Buenos Aires, Argentina. Aim: The aim of this study was to assess the effects of treatment with our locally produced P-32 colloidal suspension on knee synovitic inflammations of hemophilic and rheumatoid arthritis (RA) patients, as well as to compare results with chemical synovectomy or corticoid intra-articular injections and evaluate the cost-benefit ratio. Materials and Methods: Thirty-six hemophilic male patients, 4–28 years of age and sent by the Hemophilic Foundation (Buenos Aires, Argentina), were enrolled for knee radiosynovectomy (RS) with P-32 colloid (26 patients), or the antibiotic rifampicin with the cooperation of orthopaedists (10 patients). Parents' informed consent was obtained. The following procedures were performed: routine blood tests, X-ray, ultrasound, a 3-phase bone scan, plus monthly methylene diphosphonate (MDP) controls. Patients were included in this study only if several knee episodes had occurred. Exclusion criteria included bone destruction and big Baker's cyst. Twelve RA patients were included, with similar selection criteria: 6 RA patients received P-32 therapy, and the other 6 patients intra-articular corticoids. Clinical, blind evaluation (state of joint involvement, pain, motility, requirements of antihemophilic factors, corticoids, or analgesics) was registered in follow-up charts. If required, joint aspiration was carried out. Intra-articular instillation of saline plus flushing was done before the needle was withdrawn. P- 32 Bremsstrahlung emission was used in the gamma camera for early and late imaging to confirm the absence of leakage. For intra-articular chemical injections therapy, 4 MBq of Tc-99m MAA (macroaggregates) was used. Immobilization and relative rest for 72 hours followed the procedures. Results: There were neither local or systemic effects, nor leakage during P-32 treatment. Intra-articular rifampicin and corticoids procedures required frequent injections. Comparison of regions of interest (ROIs) in treated knees during soft-tissue scintigraphies in pre- and post-third MDP control showed knee improvement. The follow-up evaluation demonstrated an increase in joint motion, diminished volume, and less requirement and frequency of the use of antihemophilic factors (AHF) in 80% of the radiosynovectomies (21 of 26), thus lowering health costs. Five female RA patients (5 of 6) had decreased joint swelling and pains, resulting in increased joint motion. Conclusions: Radiosynovectomy in RA showed a 3-month pain palliative effect. One intra-articular knee radiosynoviorthesis in haemophilic patients provides a more than 3- month relief of symptoms after treatment with locally produced P-32 (11 patients). This turned out to be a safe, economic alternative procedure in emerging nations where the availability of AHF is difficult and expensive.  This paper was cited by:Labelled compounds as radiopharmaceuticals for radiosynoviorthesis F. Melichar, M. Kropacek, J. Srank, M. Beran, M. Mirzajevova, J. Zimova, K. Eigner-Henke, M. Forsterova Journal of Radioanalytical and Nuclear Chemistry. Jun 2009, Vol. 280, No. 2: 353-358 CrossRef The co effect of prophylaxis and radiosynovectomy on bleeding episodes in haemophilic synovitis J. BRECELJ, V. BOLE, M. BENEDIK-DOLNIČAR, M. GRMEK Haemophilia. Jun 2008, Vol. 14, No. 3: 513-517 CrossRef EFFECTS OF YUNKE (TECHNETIUM-99 CONJUGATED WITH METHYLENE DIPHOSPHONATE;
99
Tc-MDP) AND/OR COLLOIDAL CHROMIC PHOSPHATE PHOSPHONIUM-32, ALONE AND IN COMBINATION, IN RATS WITH ADJUVANT ARTHRITIS Liming Wang, Qiangrong Gu, Yan Xu, Shaohua Li, Jianchao Gui, Jianping Yang, Qingqiang Yao, Yong Ji Clinical and Experimental Pharmacology and Physiology. Feb 2008, Vol. 35, No. 1: 23-28 CrossRef Radiation synovectomy with 90Y colloid in the therapy of recurrent knee joint effusions in patients with inflammatory joint diseases Beata Chrapko, Robert Zwolak, Anna Nocuń, Renata Gołębiewska, Maria Majdan Rheumatology International. Jun 2007, Vol. 27, No. 8: 729-734 CrossRef Radiosynoviorthesis of Knees by Means of 166Ho-Holmium-Boro-Macroaggregates Otakar Kraft, Richard Kašpárek, Vojtěch Ullmann, František Melichar, Martin Kropáček, Marcela Mirzajevova Cancer Biotherapy & Radiopharmaceuticals. Apr 2007, Vol. 22, No. 2: 296-302 Abstract | Full Text PDF | Reprints & Permissions32
P colloid radiosynovectomy in treatment of chronic haemophilic synovitis: Iran experience S. M. J. MORTAZAVI, S. ASADOLLAHI, M. FARZAN, S. SHAHRIARAN, M. AGHILI, S. IZADYAR, M. LAK Haemophilia. Apr 2007, Vol. 13, No. 2: 182-188 CrossRef The Suppressive Effect of Rifampicin in Animal Model of Hemophilic Synovitis Sang-Hoon Lee, Yeon-Ah Lee, Eun-Kyung Park, Kyung-Soo Kim, Yonn-Jae Cho, Jung-Soo Han, Myung-Chul Yoo, Hyung-In Yang The Journal of the Korean Rheumatism Association. Feb 2007, Vol. 14, No. 3: 201 CrossRef
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