• Athanasios Bikas, Mark Schneider, Sameer Desale, Frank Atkins, Mihriye Mete, Kenneth D Burman, Leonard Wartofsky, and Douglas Van Nostrand.
• Division of Endocrinology (A.B., K.D.B., L.W.), Department of Medicine, MedStar Health Research Institute (A.B., S.D., M.M.), and Division of Nuclear Medicine (M.S., F.A., D.V.N.), MedStar Washington Hospital Center, Washington, DC 20010.
• J. Clin. Endocrinol. Metab. 2016 Apr 1; 101 (4): 1762-9.

ObjectiveThe objective of the study was to evaluate the effects of dosimetrically guided I-131 prescribed activities on hematopoiesis reflected by changes in complete blood counts (CBCs).DesignThis was a retrospective analysis.SettingThe study was conducted at an academic center.PatientsA total of 152 patients with differentiated thyroid cancer who had 185 dosimetrically guided I-131 treatments.InterventionsThere were no interventions.Main Outcome MeasuresRepeated-measure ANOVA was used for the analysis of the differences in the averages of CBCs that were documented at baseline and 1, 6, 12, 24–36, and 48–60 months after I-131 treatment.ResultsAll parameters decreased to their respective nadir at 1 month and then gradually returned toward baseline values. White blood cells (WBCs) and platelets (PLTs) were the most significantly affected cells. At 1 month, the decrease was 29.6% (P < .0001) for WBCs and 25% (P < .0001) for PLTs, whereas at 12 months, the decrease was 15.5% (P < .0001) and 13% (P < .0001), respectively. Lymphocytes appeared to be more susceptible to I-131 than neutrophils (ANCs). The decreases were small in absolute numbers for red blood cells, hematocrit and hemoglobin not surpassing 10%. Multivariate analysis demonstrated that the ratio of administered prescribed activity-to-maximum tolerated activity was associated with the decreases in WBCs (P = .0038), ANCs (P = .0063), and red blood cells (P = .029), with borderline significance for PLTs (P = .057) and hemoglobin (P = .057).ConclusionsDosimetrically guided I-131 resulted in statistically significant decreases in CBC parameters, which were more prominent in WBCs and PLTs. Lymphocytes were more severely affected than ANCs, whereas all parameters reached a nadir at 1 month and then gradually returned toward baseline values over the 5-year follow-up of our study.

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