177Lu-DOTATATE 是治疗转移性或不可切除神经内分泌肿瘤的有效二线治疗药物。这种治疗可能会导致血液学严重不良反应（SAR）。预先识别有 SAR 风险的患者可以减轻这种风险并提高治疗安全性和结果。方法：获得 126 名连续接受 177Lu-DOTATATE 治疗的患者的人口统计学和肿瘤学史、治疗前实验室值和 SAR 频率。单变量和多变量逻辑回归模型确定了与 SAR 相关的因素。结果：相对治疗前贫血、白细胞减少、血小板减少和平均红细胞体积 (MCV) 升高与 SAR 显着相关，MCV 大于 95 fL 的患者的优势比为 16（95% CI，5-65）。结论：治疗前骨髓恶液质，包括 MCV 大于 95 fL，可以预测接受 177Lu-DOTATATE 治疗时存在 SAR 风险的患者。需要进一步研究来确定 SAR 对这些患者的风险是否大于益处。© 2024，核医学和分子影像学会。

177Lu-DOTATATE is an effective second-line treatment for metastatic or nonresectable neuroendocrine tumors. This treatment can result in hematologic severe adverse reactions (SARs). Preemptive identification of patients at risk of SARs could mitigate this risk and improve treatment safety and outcomes. Methods: Demographic and oncologic history, pretreatment laboratory values, and SAR frequency were obtained for 126 sequential patients treated with 177Lu-DOTATATE. Univariable and multivariable logistic regression models identified factors correlating with SARs. Results: Relative pretreatment anemia, leukopenia, thrombocytopenia, and elevated mean corpuscular volume (MCV) were significantly correlated with SARs, with an odds ratio of 16 (95% CI, 5-65) in patients with an MCV greater than 95 fL. Conclusion: Pretreatment bone marrow dyscrasias, including an MCV greater than 95 fL, may predict patients at risk for SARs when treated with 177Lu-DOTATATE. Further study is needed to determine whether the risks of SARs outweigh the benefit in these patients.© 2024 by the Society of Nuclear Medicine and Molecular Imaging.