observed in this patient included not only serious deviation firom the

chromosomes but numerous breaks, deleticns and fragmentations (see attached
Occasionally dicentric forms were observed and several examples of 4n nucl
reduplication of chromosome sets, but without the exact number of 92.

Thesa@

nuclei

were presumably similar to those seen in the thyroids which built up excess

but failed to divide following 1317.

DNA

These observations were the first re

¢ yntry on chromosomal anomalies in circulating leukocytes of patients trea
I.

Macintyre, M. N., and Dobyns, B.M.: Anomalies in Chromosomes of the Ci
Leukocytes in Man Following Large Doses of Radioactive Iodine. J. Clin.

Metab. 22:

1171-1181, 1962.

One of the most important parts of these chromsome observations was

an 18% incidence of anomalies was found in the circulating leukocytes of
blood before the large treatment dose of 131] was given.

Presumably this

the fact that

thif patient's
unpsually

high rate of anomalies before this treatment was attributable to the previoug radiaticn
2ffect, which had occurred six years and more before.

This incidence far suppassed

the 4.5% nonmodal chromosome counts observed in normals in this laboratory.

}Furthermore,

the structural anomalies observed in this patient are extremely rare in contfol bilocds.

Fortunately, the usual numerous sticiies performed under this contract
hid been
zarried out on this patient when we had given previous treatment doses. It Bad been
observed then that very significant suppression of circulating lymphocytes
had cccurred
with each of the previous treatment doses 6 years and more before. Repeated|chramatograms
ind other bicchemical studies of the blood following these earlier treatmentIdoses showed

1 marked rise in mono- and diicdotyrosine anda decline in the butanol extrdctable
radioactivity in the circulation. These are all features which we had come fo believe
ere evidences of radiation effect. The value of very long term detailed
stikdy
idvantage of being "tooled up" for such studies when the opportunity arises Yas
iustrated in this case.

The fact that a considerable population of cells with abnormal numbers ¢@f

and the
well

chromosomes

ilpparently persisted in this
patient for at least 6 years. as shown in the b]bod drawn
efore the present dose of 1512 was given,seems important. If cell lines stamming frem
somatic cells which bear such anomalies can remain viable, the same might be ftrue of
similarly affected reproductive cells in the gonads. If such a large mmber[of chromsaml
thanges are demonstrable in tissues such as blood which does not specifically concentrate
31y, then significant alterations in other similar nonthyroidal celis such ds the
eproductive cells should be considered even with much smaller doses of 13iz]
it is
ossible that the less devastating doses of 1311 may be more important becauge smaller
oses may not be lethal although,perhaps more serious from the standpoint of Hamage to
he cells. The total dosage of
151; given this patient was far greater than [that commonly
sed in the therapy of Graves' disease.
In view of the above observations it seemed appropriate that similar observations

hould be made on patients who were receiving modest doses of

1311 for hypert

.e. 5 to 15 millicuries rather than 167 as in the above described patient.

coidisn,

Pavid '

atcher, a Ph.D. student with Dr. Macintyre, continued this project to dete
e whether
here is a significant increase in anomalies in patients we selected for treafiment of
raves' disease with 1211. om patients selected were studied in great detail, as

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