# Phosphorus-32 (radiophosphorus)

Source: https://onco.cc/drugs/phosphorus-32/  
OnCo record `phosphorus-32` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Radiophosphorus was one of the first treatments for polycythaemia vera, from the 1940s: a radioactive phosphate injection that quietened the overactive bone marrow for a year or more. It was abandoned when trials showed it raised the risk of leukaemia.

## Summary

Phosphorus-32 was introduced by John Lawrence at Berkeley in the late 1930s as the first therapeutic use of an artificial radionuclide, and became a standard treatment for polycythaemia vera and essential thrombocythaemia. A single intravenous dose controlled blood counts for one to two years and was convenient for older patients.

The Polycythemia Vera Study Group's first randomised trial, launched in 1967, compared phlebotomy alone, phlebotomy plus radiophosphorus and phlebotomy plus chlorambucil, and showed that both radiophosphorus and chlorambucil raised the risk of acute leukaemia several-fold. Radiophosphorus was thereafter restricted to the very elderly and is now rarely used, replaced by hydroxyurea, interferon and JAK inhibitors. The polycythaemia vera page records it in the history of the disease.

## Fields

- Kind: Treatment
- Status: historic
- Last checked: 2026-09-17
- Also known as: Radiophosphorus; Sodium phosphate P-32; 32P
- Tags: subtype-drugs-wave
- Modality: Intravenous radiopharmaceutical (beta emitter; historic)
- Mechanism: Phosphate labelled with the beta emitter phosphorus-32 is taken up by rapidly dividing marrow cells and incorporated into their DNA, where the radiation suppresses the overactive marrow of polycythaemia vera.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Phosphorus-32
- Wikipedia: https://en.wikipedia.org/wiki/Phosphorus-32

## Connected records

- drugs: [Chlorambucil](https://onco.cc/drugs/chlorambucil/), [Hydroxyurea (hydroxycarbamide)](https://onco.cc/drugs/hydroxyurea/)
- cancers: [Polycythaemia vera (PV)](https://onco.cc/cancers/polycythaemia-vera/)
- trials: [CYTO-PV](https://onco.cc/trials/cyto-pv/)

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JSON: https://onco.cc/api/v1/entities/phosphorus-32.json