[Determinants for iron overload in patients with acute leukemias and aplastic anemia].
OBJECTIVE
to reveal the determinants of the development of iron overload in patients with acute leukemias (AL) and aplastic anemia (AA).


METHODS
The investigation included 104 patients, including 64 with various types of AL, 31 with AA, and 9 with myelodysplastic syndromes (MDS). A group affiliation and an erythrocyte phenotype were determined from rhesus system antigens in all the patients and the HFE gene was studied to identify mutations. For control of siderosis, the authors determined serum iron (SI) by a colorimetric technique, by applying the kits of the AGAT firm (Russia), serum ferritin (SF) by an immunoradiometric method, by using the kits of Immunotech (Czechia). The volume of transfusion was estimated in the period of June 2007 to November 2009.


RESULTS
There is evidence for a relationship between the higher level of SF and the number of transfusions. SF was 1046.1 microg/l in patients, H63D heterozygous carriers who had received less than 10 packed red blood cell transfusions and 2856 microg/l in those who had 20 transfusions (p < 0.005). HFE gene mutation carriage accelerates iron accumulation and is an additional risk factor for siderosis. In patients with transfusion chimeras and a rare phenotype in terms of rhesus antigens, packed red blood cell transfusion results in a much more increase in iron stores.


CONCLUSIONS
The most important factor of iron overload acceleration is no specific choice of packed red blood cells for patients with rare combinations of red blood cell antigens and for those with artificially induced chimeras.
Makeshova
A B
AB
Levina
A A
AA
Mamukova
Iu I
IuI
Tsibul'skaia
M M
MM
Makarova
P M
PM
Romanova
E A
EA
Fevraleva
I S
IS
Sudarikov
A B
AB
Golovkina
L L
LL
Stremoukhova
A G
AG
Parovichnikova
E N
EN
Savchenko
V G
VG
D000208:Acute Disease; D000741:Anemia, Aplastic / Q000097:blood* / Q000235:genetics / Q000628:therapy; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000706:statistics & numerical data; D004912:Erythrocytes / Q000166:cytology; D005293:Ferritins / Q000097:blood; D000071020:Hemochromatosis Protein; D006486:Hemosiderosis / Q000097:blood* / Q000209:etiology / Q000235:genetics / Q000628:therapy; D006579:Heterozygote; D015395:Histocompatibility Antigens Class I / Q000235:genetics*; D006720:Homozygote; D006801:Humans; D007501:Iron / Q000097:blood*; D007938:Leukemia / Q000097:blood* / Q000235:genetics / Q000628:therapy; D008565:Membrane Proteins / Q000235:genetics*; D009154:Mutation; D011863:Radioimmunoassay; D012204:Rh-Hr Blood-Group System / Q000235:genetics; D012307:Risk Factors
C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins; D012204:Rh-Hr Blood-Group System; D005293:Ferritins; D007501:Iron