Spectrum of therapy-related clonal cytopenias and neoplasms after exposure to Lutetium-177-Dotatate

•Lutetium-177-Dotatate is used in the treatment of neuroendocrine neoplasms.•We report our experience with hematologic dysfunction after 177Lu-Dotatate.•4 % of patients developed a therapy-related neoplasm or clonal cytopenia.•The median latency after first PRRT treatment was 18.5 months.•Recurrent high-grade chromosomal damage was observed in patients exposed to PRRT.