Berta Dereje Mengesha, Teketelew Bisrat Birke, Cherie Negesse, Tamir Mebratu, Abriham Zufan Yiheyis, Ayele Angelo Abiy, Tarekegne Amare Mekuanint, Chane Elias, Mulatie Zewudu, Walle Muluken
Department of Hematology and Immunohematology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Department of Quality Assurance and Laboratory Management, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Front Endocrinol (Lausanne). 2025 Mar 14;16:1562851. doi: 10.3389/fendo.2025.1562851. eCollection 2025.
Patients with thyroid cancer (TC) are commonly treated with radioactive iodine therapy (RIA) to prevent neoplastic transformation and the re-emergence of cancer cells. However, it has major side effects on blood cells. However, the degree of change in hematological parameters reported varies across studies. Therefore, the aim of this review was to assesses the mean differences in hematological parameters after RAI therapy.
The relevant articles for this review were identified through extensive searches of databases and the Google search engine. The identified articles were subsequently selected using predetermined eligibility criteria. All relevant information from the screened articles was extracted. The pooled standardized mean differences (SMDs) of the parameters were assessed via a random effects model. The heterogeneity was determined by I statistics test. Funnel plots and Egger's test were utilized to assess publication bias.
A total of 17 studies including 4,112 and 3,766 study participants before and after RAI therapy, respectively, were included. The pooled SMDs of the total leucocyte count (TLC) (*10/L) at one, three, six and 12 months and the last follow-up period were 2.39, 2.46, 5.84, 3.19, and 0.53, respectively. Changes in the TLC after one, three and six months of therapy were statistically significant. In terms of the absolute neutrophil count (ANC; *10/L) and absolute lymphocyte count (ALC; *10/L), the pooled SMDs at the last follow-up period were 6.32 and 7.37, respectively. In addition, statistically significant changes in the platelet count (PLT; *10/L) were observed at one, three, six and 12 months and at the last follow-up, with pooled SMDs of 7.01, 0.22, 2.63, 6.61, and 8.76, respectively. Furthermore, statistically significant changes in red blood cells (RBCs; *10/L) and hemoglobin (Hgb; g/dl) were detected after three and six months of therapy, with pooled SMDs of -1.088 and 2.4, respectively.
According to the current systematic review and meta-analysis, radioiodine therapy had a significant effect on hematological parameters. Thus, early screening and correction of hematological toxicity may be helpful for improving quality of life in thyroid cancer patients receiving radioiodine therapy.
https://www.crd.york.ac.uk/prospero/, identifier CRD42024586449.
甲状腺癌（TC）患者通常接受放射性碘治疗（RIA）以预防肿瘤转化和癌细胞复发。然而，它对血细胞有 major 副作用。然而，不同研究报道的血液学参数变化程度各不相同。因此，本综述的目的是评估放射性碘治疗后血液学参数的平均差异。
通过广泛检索数据库和谷歌搜索引擎确定本综述的相关文章。随后使用预先确定的纳入标准选择已识别的文章。从筛选出的文章中提取所有相关信息。通过随机效应模型评估参数的合并标准化平均差异（SMD）。通过I统计检验确定异质性。使用漏斗图和Egger检验评估发表偏倚。
共纳入17项研究，分别包括放射性碘治疗前的4112名和治疗后的3766名研究参与者。在1个月、3个月、6个月、12个月和最后随访期，白细胞总数（TLC；*10/L）的合并SMD分别为2.39、2.46、5.84、3.19和0.53。治疗1个月、3个月和6个月后TLC的变化具有统计学意义。就绝对中性粒细胞计数（ANC；*10/L）和绝对淋巴细胞计数（ALC；*10/L）而言，最后随访期的合并SMD分别为6.32和7.37。此外，在1个月、3个月、6个月、12个月和最后随访时观察到血小板计数（PLT；*10/L）有统计学意义的变化，合并SMD分别为7.01、0.22、2.63、6.61和8.76。此外，治疗3个月和6个月后检测到红细胞（RBCs；*10/L）和血红蛋白（Hgb；g/dl）有统计学意义的变化，合并SMD分别为-1.088和2.4。
根据目前的系统评价和荟萃分析，放射性碘治疗对血液学参数有显著影响。因此，早期筛查和纠正血液学毒性可能有助于提高接受放射性碘治疗的甲状腺癌患者的生活质量。
