Patient Release Related to
Gamma Emissions

• According to Nuclear Regulatory Commission (NRC) Guidelines, patient is releasable if total effective dose equivalent to other individuals "is not likely to exceed" 500 mrem
• Patient-specific dose calculations were developed
  • Total body residence time (TBRT) determined by dosimetry calculation
  • Measured Dose Rate (mrem/h) at 1 meter
  • Look-Up Table – to determine whether particular TBRT and Measured Dose Rate allow release
  • Virtually all patients can be released on the same day as the therapeutic infusion
  Siegel JA et al. J Nucl Med 2002;43:354-363.

  Rutar FJ et al. J Nucl Med 2001;42:907-915.

Radiation Exposure: Relative Risks

• NRC rule
  • Allowable exposure = 500 mrem
• Measured exposure from a patient post BEXXAR^{® 1}
  • Median exposure of household member = 150 mrem based on patients receiving 30-75 cGy of TBD of BEXXAR^®
• Equivalents = 500 mrem exposure²
  • Living 1.4 years in the USA
  • 4 mammograms
  • One fifth of a CT scan
  1. Rutar FJ et al. J Nucl Med 2001; 42:907-915.

  2. US Department of Energy. Radiation in Perspective. June 2003.

Study of Outpatient Treatment With BEXXAR^®: Radiation Exposure to Family Members

• Study Objective: To determine the radiation doses received by maximally exposed members from patients who received BEXXAR

• Method: 26 family members of the 22 patients were provided with radiation monitoring devices (worn for 2 to 17 days). Patients received BEXXAR TBD 30 to 75 cGy (25-129 mCi)
• Results: The measured dose values ranged from 17 to 409 mrem

• Conclusion: Patients can be released immediately with confidence that doses to other individuals should be below the 500 mrem limit

Instructions to Patients

The following instructions should be followed for approximately 1-2 weeks:

• Stay at least 6 feet away from other people when possible
• Sleep in a separate bed
• Do not take long trip (4 hours or more) sitting near others in car, airplane, or bus
• Avoid contact with children or pregnant women
• Have sole use of bathroom; sit when urinating and flush toilet three times with lid down
• Wash hands frequently; shower daily

• The following instructions should be followed for approximately 1 to 2 weeks:
• Keep dishes/utensils separate from household; wash separately
• Use separate toothbrush, towels and washcloths
• Wait 1 week before washing towels and sheets
• Wash laundry separately
• Bag and throw out trash separately
• Menstruating women should use tampons that can be flushed down the toilet