Gmür J, Bischof B, Coninx S, Bucher U, Poretti G, Henrichs K, Kaul A, Roedler H D, Büttner K, Frick P G
Blood. 1983 Apr;61(4):746-50.
Two patients with polycythemia vera received intravenously an accidental tenfold overdosage of radiophosphorus therapy (60 and 50 mCi 32P, respectively). In both patients, the occurrence of hemorrhagic complications 3 wk after the 32P medication led to detection of the error and referral to our hospital. Upon admission they showed an agranulocytosis, severe thrombocytopenia, and bone marrow aplasia. In both cases, spontaneous recovery of the hematopoiesis was observed from day 40 posttreatment onward. In one patient, a slow but ultimately complete normalization of blood counts and marrow morphology took place, whereas in the other, a mild thrombocytopenia persists. Nearly 5 yr after the accidental overdosage, both patients are clinically well. Symptoms of polycythemia vera have not reappeared up to now. Attempts were made to evaluate the radiation dose absorbed by the bone marrow. In the first patient, the daily 32P excretion was determined from day 22 to day 60, whereas in the other patient a whole body count was performed on day 78 after administration. From these results, an approximate cumulative bone marrow dose of 10 Sv (1000 rem) could be calculated.
两名真性红细胞增多症患者静脉内意外接受了十倍剂量的放射性磷治疗（分别为60和50毫居里的32P）。两名患者在服用32P药物3周后均出现出血并发症，从而发现了这一错误并转诊至我院。入院时，他们表现出粒细胞缺乏、严重血小板减少和骨髓再生障碍。在两例患者中，均观察到治疗后第40天起造血功能自发恢复。其中一名患者，血细胞计数和骨髓形态缓慢但最终完全恢复正常，而另一名患者则持续存在轻度血小板减少。意外过量用药近5年后，两名患者临床状况良好。截至目前，真性红细胞增多症的症状未再出现。尝试评估骨髓吸收的辐射剂量。在第一名患者中，从第22天到第60天测定每日32P排泄量，而在另一名患者中，给药后第78天进行全身计数。根据这些结果，可以计算出骨髓的累积剂量约为10希沃特（1000雷姆）。
