Practical implications of liver and heart iron load assessment by T2*-MRI in children and adults with transfusion-dependent anemias.
This study examined the relationship between hepatic and myocardial iron concentration, assessed by T2*-MRI in 66 patients (3-82 years) with transfusion-dependent anemias and thalassemia intermedia, to determine whether hepatic iron levels alone suffice for chelation adjustments. We found a poor correlation between hepatic and myocardial iron (r = 0.10, P = 0.43) and identified a subgroup (14%) with increased myocardial iron without a matched degree of hepatic hemosiderosis. Left ventricular ejection fraction was insensitive for detecting elevated myocardial iron. These findings were present in both adult and pediatric patients. We recommend therapeutic monitoring of iron burden by evaluation of both liver and myocardial iron with T2*-MRI.
Deborah Chirnomas
Sarah
S
Division of Hematology/Oncology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA. deborah.chirnomas@childrens.harvard.edu
Geukes-Foppen
Marnix
M
Barry
Kristen
K
Braunstein
Jennifer
J
Kalish
Leslie A
LA
Neufeld
Ellis J
EJ
Powell
Andrew J
AJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008099:Liver / Q000000981:diagnostic imaging / Q000378:metabolism*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009206:Myocardium / Q000378:metabolism*; D011859:Radiography; D012189:Retrospective Studies; D013789:Thalassemia / Q000000981:diagnostic imaging / Q000378:metabolism; D065227:Transfusion Reaction; D018487:Ventricular Dysfunction, Left
D007501:Iron