Micronucleus evaluation for determining the chromosomal breakages after radionuclide synovectomy in patients with hemophilia

Objective To investigate the genotoxic effects of 90 Y and 186 Re in patients with hemophilia who were undergoing radionuclide synovectomy (RS) procedure in the last 3 years. Methods Nineteen patients were enrolled in the study. Most of the patients ( n = 17) were hemophilia-A (mean age 20.6 ± 10.5 years) and 18 patients (mean age 22.6 ± 10.6 years) with hemophilia who were not exposed to RS procedure were included in the study as control group. Most cases in the control group ( n = 13) were hemophilia-A. 90 Y for knee joints and 186 Re for elbow or ankle joints were used to perform RS in hemophilic patients. We studied the micronucleus (MN) test on peripheral blood lymphocytes as an indicator of radiation-induced cytogenetic damage and calculated nuclear division index. Results There was no significant difference between the patients with and without RS with respect to MN values. However, both values obtained in RS-exposed patients and control group were much elevated than values reported in literature from healthy controls. The mean MN values of patients below 20 years old were much lower but not significant than those above 20 years old. MN frequencies between 186 Re and 90 Y groups were also analyzed, and no significant difference was observed. Hemophilia patients who were treated with 186 Re showed higher levels of MN compared to patients treated with 90 Y although the difference was not significant. Conclusions Radioisotope synovectomy (RS) seems to be a safe procedure not causing a significant genotoxic effect on hemophilic patients, however, further studies including larger series of patients are needed to better understand the effects of RS on patients’ health.