{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T15:37:07Z","timestamp":1793893027149,"version":"4.8.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T00:00:00Z","timestamp":1637193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mainly severe (CTCAE grade 3\u20134) haematotoxicity during peptide receptor radionuclide therapy (PRRT) is reported in literature due to major clinical impact, however moderate (CTCAE grade 2) haematotoxicity is common and could affect therapy management. The aim of this study was to evaluate the haematotoxicity course during PRRT and to compare baseline parameters between haematotoxicity grades.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective study, 100 patients with a neuroendocrine tumour treated with PRRT were included. Patients were treated with an aimed number of four cycles with 7.4 GBq [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-DOTA-TATE administered every 10 weeks. Haematological assessment was performed at baseline and frequently up to 10 weeks after the fourth cycle. The lowest haematological value was graded according to CTCAE v5.0, and patients were classified using the highest observed grade. Differences in baseline parameters, including [\n                      <jats:sup>68<\/jats:sup>\n                      Ga]Ga-DOTA-TATE positive tumour volume, were evaluated between CTCAE grades.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four cycles were completed by 86\/100 of patients, 4\/100 patients discontinued due to haematotoxicity, and 10\/100 patients due to progressive disease. The treatment course was adjusted due to haematotoxicity in 24\/100 patients, including postponed next cycle (n = 17), reduced administered activity (n = 13), and both adjustments (n = 10). The most observed haematotoxicity grade was grade 0\u20131 in 54\/100 patients, grade 2 in 38\/100 and grade 3\u20134 in 8\/100. Significant differences in baseline leucocyte, neutrophil and platelet counts were observed between grade 0\u20131 and grade 2. However, the correlation between baseline and lowest observed values was poor to moderate. No differences between haematotoxicity grades and baseline parameters or somatostatin receptor positive tumour volume was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The incidence of severe haematotoxicity was low with extensive screening and monitoring. The vast majority of patients (96\/100) was not restricted in treatment continuation by haematotoxicity; therefore, our selection criteria appeared appropriate for safe PRRT treatment. Baseline parameters showed limited correlation with the degree of decline in haematological values.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0260073","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T13:35:55Z","timestamp":1637242555000},"page":"e0260073","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Haematotoxicity during peptide receptor radionuclide therapy: Baseline parameters differences and effect on patient\u2019s therapy course"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1967-8148","authenticated-orcid":true,"given":"Daphne M. V.","family":"de Vries\u2013Huizing","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle W. J.","family":"Versleijen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Sinaasappel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Walraven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine M.","family":"Geluk\u2013Jonker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margot E. T.","family":"Tesselaar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen J. M. A.","family":"Hendrikx","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berlinda J.","family":"de Wit\u2013van der Veen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel P. M.","family":"Stokkel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"issue":"2","key":"pone.0260073.ref001","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1056\/NEJMoa1607427","article-title":"Phase 3 trial of 177Lu-Dotatate for midgut neuroendocrine tumors","volume":"376","author":"J Strosberg","year":"2017","journal-title":"N Engl J Med"},{"issue":"25","key":"pone.0260073.ref002","doi-asserted-by":"crossref","first-page":"2578","DOI":"10.1200\/JCO.2018.78.5865","article-title":"Health-related quality of life in patients with progressive midgut neuroendocrine tumors treated with 177Lu-Dotatate in the phase III NETTER-1 trial.","volume":"36","author":"J Strosberg","year":"2018","journal-title":"J Clin Oncol"},{"key":"pone.0260073.ref003","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1007\/s00259-008-0778-1","article-title":"Long-term evaluation of renal toxicity after peptide receptor radionuclide therapy with 90Y-DOTATOC and 177Lu-DOTATATE: the role of associated risk factors","volume":"35","author":"L Bodei","year":"2008","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"12","key":"pone.0260073.ref004","doi-asserted-by":"crossref","first-page":"2754","DOI":"10.1200\/JCO.2005.08.066","article-title":"Radiolabeled somatostatin analog [177Lu-DOTA0,Tyr3]octreotate in patients with endocrine gastroenteropancreatic tumors","volume":"23","author":"DJ Kwekkeboom","year":"2005","journal-title":"J Clin Oncol"},{"issue":"1","key":"pone.0260073.ref005","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s00259-014-2893-5","article-title":"Long-term tolerability of PRRT in 807 patients with neuroendocrine tumours: the value and limitations of clinical factors","volume":"42","author":"L Bodei","year":"2014","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"pone.0260073.ref006","article-title":"Therapy-related hematological malignancies after peptide receptor radionuclide therapy with 177Lu-DOTA-Octreotate: Incidence, course & predicting factors in patients with GEP-NETs","author":"H Bergsma","year":"2017","journal-title":"J Nucl Med"},{"issue":"7","key":"pone.0260073.ref007","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1001\/jamaoncol.2020.0078","article-title":"Assessment of therapy-related myeloid neoplasms in patients with neuroendocrine tumors after peptide receptor radionuclide therapy: a systematic review","volume":"6","author":"MB Sonbol","journal-title":"JAMA Oncol. 2020"},{"issue":"5","key":"pone.0260073.ref008","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1007\/s00259-012-2330-6","article-title":"The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours.","volume":"40","author":"JJ Zaknun","year":"2013","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"pone.0260073.ref009","unstructured":"National Cancer Institute-Common Toxicity Criteria Adverse Events v5.0. 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