Iron overload in survivors of childhood leukemia after allogeneic hematopoietic stem cell transplantation.
Iron overload has not been studied extensively and prospectively in pediatric survivors of allogeneic hematopoietic stem cell transplantation (HSCT); therefore, we conducted a prospective long-term study of 133 survivors of childhood leukemia to assess the incidence of and risk factors for iron overload and to investigate its association with organ dysfunction. One yr after HSCT, the mean serum ferritin level was 1158 ng/mL (range, 22-3264 ng/mL), with 124 patients (93.2%) having a serum ferritin level that exceeded the upper limit of the normal range (110 ng/mL). Thereafter, the serum ferritin level declined over time. There was a positive correlation between the level of serum ferritin and that of total bilirubin (r = 0.21, p < 0.001) and glutamate pyruvate transaminase (r = 0.17, p < 0.001). A high concentration of serum ferritin was associated with low cardiac fractional shortening (r = -0.15, p = 0.047). In addition, patients with hypothyroidism and GH deficiency had a higher level of serum ferritin than those without (p < 0.02). We conclude that iron overload is common after HSCT and is associated with hepatic, cardiac, and endocrine dysfunction.
Division of Bone Marrow Transplantation and Cellular Therapy, Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
Thirachit
T
Chotsampancharoen
Kwan
K
Gan
Kimberly A
KA
Kasow
Raymond C
RC
Barfield
Gregory A
GA
Hale
Wing
W
Leung
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004700:Endocrine System Diseases / Q000209:etiology; D005260:Female; D005293:Ferritins / Q000097:blood; D006331:Heart Diseases / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007223:Infant; D019190:Iron Overload / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D007938:Leukemia / Q000628:therapy*; D008107:Liver Diseases / Q000209:etiology; D008297:Male; D012307:Risk Factors; D014184:Transplantation, Homologous; D055815:Young Adult
D005293:Ferritins