Clinical Studies With the Aid of Radioactive Phosphorus. I. The Absorption and Distribution of Radio-Phosphorus in the Blood and Its Excretion by Normal Individuals and Patients With Leukemia 1

Abstract

The purpose of this paper is (a) to indicate the amount of radio-phosphorus (P32) retained by various fractions of the blood of 4 normal individuals, 12 patients with myeloid, and 15 with lymphoid leukemia, and the variations in retention following the administration of radio-phosphorus when given orally and/or intravenously and when accompanied by varying amounts of non-radioactive phosphorus (P31); (b) to indicate the distribution of pS2 in the bone marrow and in various fractions of white blood cells; and (c) to indicate the amount of radio-phosphorus excreted in urine and feces in these cases. MATERIALS AND METHODSThe radioactive phosphorus was produced by the Berkeley cyclotron (1). The 4 normal individuals were robust, ambulatory workmen with recently healed fractures, all of whom had received the same type and quantity of food over a period of from 1 to 8 weeks, and each of whom had a single regular bowel movement daily during the same period previous to the administration of P'. It was impossible to control the diets or the time of excretion of the patients, all of whom were ambulatory. The blood withdrawn from veins was heparinized, cooled and centrifuged exactly 20 minutes at 1450 times gravity to insure constant volume. The buffy coat was aspirated, suspended in equal amounts of heparinized Ringer's solution and centrifuged exactly 20 minutes at 1450 times gravity. The plasma was then removed from the original tube and finally the red blood cells were extracted. Bone marrow obtained by sternal aspiration was heparinized and centrifuged, as described previously. In some instances, the nuclei were separated from the cytoplasm of the peripheral white blood cells by violent agitation for 20 minutes in cold 5 per cent citric acid (2). The phospholipids were extracted from the white blood cells by the use of ether, alcohol and reflux condensers, and the acid-soluble substances by use of ice-cold 5 per cent trichloracetic acid, thereby leaving 1 These investigations have been aided by a grant from the John and Mary R. Markle Foundation.2Wm. R. Kenan, Jr., Fellow.the nucleoprotein-like substances as residue (3). The assays of radioactivity were made by use of an electrometer.RESULTS

A Primer on Radiopharmaceutical Therapy

“…Fundamentally, radiopharmaceutical therapy (RPT) involves the delivery of radionuclides, both unconjugated and unconjugated, for use in the treatment of patients with cancer. Successful uses of therapeutic radiation date to the 1940s when Saul Hertz used 130 I and 131 I to treat patients with hyperthyroidism, and when others evaluated 32 P for the treatment of leukemias (1,2). The original application of radioactive iodine took advantage of its physiologic uptake (e.g.…”

Radiotheranostics - Precision Medicine in Nuclear Medicine and Molecular Imaging

“…The concept of radiotheranostics has been clinically adopted for over 80 years now. Among the earliest examples of theranostic is the use of Phosphorus-32 ( 32 P) for leukemia in 1941 [5], and Iodine-131 ( 131 I) for Graves' disease published by Saul Hertz in 1942 [6], and subsequently thyroid cancer in 1946 [7]. Radioiodine therapies became one of the cornerstone treatments in nuclear medicine and is markedly used every day worldwide.…”

Nothing new under the nuclear sun: towards 80 years of theranostics in nuclear medicine

“…Soon after Chiewitz and de Hevesy [4] described the uptake of radioactive 32 P in the bones of rats, Erf and J.H. Lawrence (brother of the physicist Ernest O. Lawrence, who built the first cyclotron) applied this same radioisotope to patients suffering from leukaemia and polycythaemia vera [5]. Although this treatment certainly was not without success, it has since been superseded by more effective nonradioactive chemotherapy.…”