Metformin Attenuates 131I-Induced Decrease in Peripheral Blood Cells in Patients with Differentiated Thyroid Cancer.

MedStar author(s):
Citation: Thyroid. 26(2):280-6, 2016 FebPMID: 26649977Institution: MedStar Health Research Institute | MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Medicine/Endocrinology | Medicine/Nuclear MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Iodine Radioisotopes/ae [Adverse Effects] | *Iodine Radioisotopes/tu [Therapeutic Use] | *Metformin/tu [Therapeutic Use] | *Radiation-Protective Agents/tu [Therapeutic Use] | *Thyroid Neoplasms/bl [Blood] | *Thyroid Neoplasms/dt [Drug Therapy] | Adult | Aged | Blood Platelets/me [Metabolism] | Bone Marrow Cells/re [Radiation Effects] | Erythrocyte Count | Female | Hemoglobins/an [Analysis] | Humans | Hypoglycemic Agents/tu [Therapeutic Use] | Leukocyte Count | Male | Middle Aged | Reproducibility of Results | Retrospective Studies | ThyroidectomyYear: 2016Local holdings: Available online from MWHC library: August 2000 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 1050-7256
Name of journal: Thyroid : official journal of the American Thyroid AssociationAbstract: BACKGROUND: 131I treatment (tx) of differentiated thyroid cancer (DTC) is associated with hematopoietic toxicity. It was hypothesized that metformin could have radioprotective effects on bone-marrow function. The objective was to determine whether metformin prevents 131I-induced changes in complete blood counts (CBC) in patients with DTC.CONCLUSIONS: Metformin attenuated the 131I-induced decrease in CBC parameters, and its radioprotective properties were more prominent in WBC. Patients who were taking metformin during 131I tx also experienced a faster recovery in their blood counts, when compared to the control group. Further study is warranted in order to examine if the radioprotective properties of metformin observed in the current study for 131I tx can also apply to other forms of therapeutic chemo- and radiotherapy.METHODS: A retrospective analysis was performed of CBC values in DTC patients who were (40 patients: metformin group) or were not taking metformin (39 patients: control group) at the time of administration of 131I. Repeated measures analysis of variance was used for the analysis of the differences in the averages of CBC that were documented at baseline and at 1, 6, and 12 months post 131I tx.RESULTS: The groups were comparable in terms of age, sex, stage of DTC, 131I dose administered, and baseline CBC values. In the control group, the decrease in white blood cells (WBC) was 35.8% (p<0.0001) at one month, 21.8% (p<0.0001) at six months, and 19.4% (p<0.0001) at 12 months. In the metformin group, the decrease in WBC was 17.1% (p<0.0001) at one month, and 8.6% at six months (p=0.01), while at 12 months WBC had returned to baseline values (p=0.9). Differences between the two groups were highly statistically significant at all time points (p<0.0001, p=0.0027, and p<0.0001, respectively). Lymphocytes were more sensitive to 131I, but metformin's radioprotective properties were more prominent in neutrophils. At 12 months, the decrease in platelets in the control group was 15.5% (p<0.0001) versus 5.6% (p=0.056) in the metformin group, while at one and six months the reductions in the two groups were comparable. No statistically significant differences were observed between the two groups in the change from baseline values for hemoglobin.All authors: Bikas A, Burman KD, Desale S, Jensen K, Mete M, Patel A, Van Nostrand D, Vasko V, Wartofsky LFiscal year: FY2015Digital Object Identifier: Date added to catalog: 2017-03-08
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 26649977 Available 26649977

Available online from MWHC library: August 2000 - present, Available in print through MWHC library: 1999 - 2006

BACKGROUND: 131I treatment (tx) of differentiated thyroid cancer (DTC) is associated with hematopoietic toxicity. It was hypothesized that metformin could have radioprotective effects on bone-marrow function. The objective was to determine whether metformin prevents 131I-induced changes in complete blood counts (CBC) in patients with DTC.

CONCLUSIONS: Metformin attenuated the 131I-induced decrease in CBC parameters, and its radioprotective properties were more prominent in WBC. Patients who were taking metformin during 131I tx also experienced a faster recovery in their blood counts, when compared to the control group. Further study is warranted in order to examine if the radioprotective properties of metformin observed in the current study for 131I tx can also apply to other forms of therapeutic chemo- and radiotherapy.

METHODS: A retrospective analysis was performed of CBC values in DTC patients who were (40 patients: metformin group) or were not taking metformin (39 patients: control group) at the time of administration of 131I. Repeated measures analysis of variance was used for the analysis of the differences in the averages of CBC that were documented at baseline and at 1, 6, and 12 months post 131I tx.

RESULTS: The groups were comparable in terms of age, sex, stage of DTC, 131I dose administered, and baseline CBC values. In the control group, the decrease in white blood cells (WBC) was 35.8% (p<0.0001) at one month, 21.8% (p<0.0001) at six months, and 19.4% (p<0.0001) at 12 months. In the metformin group, the decrease in WBC was 17.1% (p<0.0001) at one month, and 8.6% at six months (p=0.01), while at 12 months WBC had returned to baseline values (p=0.9). Differences between the two groups were highly statistically significant at all time points (p<0.0001, p=0.0027, and p<0.0001, respectively). Lymphocytes were more sensitive to 131I, but metformin's radioprotective properties were more prominent in neutrophils. At 12 months, the decrease in platelets in the control group was 15.5% (p<0.0001) versus 5.6% (p=0.056) in the metformin group, while at one and six months the reductions in the two groups were comparable. No statistically significant differences were observed between the two groups in the change from baseline values for hemoglobin.

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