TY  - BOOK
AU  - Bikas, Athanasios
AU  - Burman, Kenneth D
AU  - Desale, Sameer
AU  - Mete, Mihriye
AU  - Van Nostrand, Douglas
AU  - Wartofsky, Leonard
TI  - Metformin Attenuates 131I-Induced Decrease in Peripheral Blood Cells in Patients with Differentiated Thyroid Cancer
SN  - 1050-7256
PY  - 2016///
KW  - *Iodine Radioisotopes/ae [Adverse Effects]
KW  - *Iodine Radioisotopes/tu [Therapeutic Use]
KW  - *Metformin/tu [Therapeutic Use]
KW  - *Radiation-Protective Agents/tu [Therapeutic Use]
KW  - *Thyroid Neoplasms/bl [Blood]
KW  - *Thyroid Neoplasms/dt [Drug Therapy]
KW  - Adult
KW  - Aged
KW  - Blood Platelets/me [Metabolism]
KW  - Bone Marrow Cells/re [Radiation Effects]
KW  - Erythrocyte Count
KW  - Female
KW  - Hemoglobins/an [Analysis]
KW  - Humans
KW  - Hypoglycemic Agents/tu [Therapeutic Use]
KW  - Leukocyte Count
KW  - Male
KW  - Middle Aged
KW  - Reproducibility of Results
KW  - Retrospective Studies
KW  - Thyroidectomy
KW  - MedStar Health Research Institute
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Medicine/Endocrinology
KW  - Medicine/Nuclear Medicine
KW  - Journal Article
N1  - Available online from MWHC library: August 2000 - present, Available in print through MWHC library: 1999 - 2006
N2  - 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
UR  - https://dx.doi.org/10.1089/thy.2015.0413
ER  -