TARGETING THE SKELETON AND CANCER IN BONE: SAMARIUM TREATMENT OF OSTEOSARCOMA, OSTEOBLASTIC BONE METASTASES, AND HEMATOLOGIC MALIGNANCY IN THE BONE MARROW

Abstract
Chemical coupling of a bone-seeking chemical moiety to a radioactive metal, samarium, has produced a new radiopharmaceutical drug that has very specific targeting to the bones and bone marrow. This allows radiation to be specifically delivered to cancers that make bone (osteosarcoma) as well as cancers that cause new bone formation when they invade bones (e.g. carcinomas such as breast cancer and prostate cancer, paragangliomas, and chondrosarsomas). This mini-review discusses some of the principles of effective use of high-dose samarium to treat malignancies involving the bones as well as hematologic malignancies involving the bone marrow (e.g. acute myelogenous leukemia and multiple myeloma). The high therapeutic benefit compared to low toxicity of high-dose samarium in our Mayo Clinic experience is described. The use of samarium as part of a sequential, comprehensive approach to cancer involving the bones and/or bone marrow is detailed

Key words
Samario, cáncer de hueso, esqueleto, radiación, leucemia mielógena aguda, osteosarcoma, metástasis óseas, gammagrafía ósea, PET, trasplante de médula ósea, rescate de células madre

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