title: Iron overload in children undergoing cancer treatments.
abstract: BACKGROUND
  Iron overload is responsible for severe morbidity and mortality in polytransfused patients. Although repeated blood transfusions are needed during the treatment of most cancers, pediatric patients are not routinely screened for subsequent iron overload.
  
  
  METHODS
  Seventy-five patients were identified as candidates for cancer treatment and enrolled prospectively in a yearly protocol including a cardiac and liver magnetic resonance imaging coupled with ferritin level measurements. Patients were divided into four groups using the intensity of treatment rating (ITR-3).
  
  
  RESULTS
  Fifty-nine patients reached 1-year of follow-up and liver iron overload was found in up to 66% of them. Such overload correlated with the total volume of red blood cells transfused and persisted at least 2 years after the initiation of therapy. Moderate myocardial overload was also, but less frequently (14%), observed in these patients.
  
  
  CONCLUSIONS
  Our study demonstrated that severe liver iron overload as well as moderate myocardial iron overload can be found 1 year after cancer treatment and that this overload persists overtime. The patients with higher ITR and those who have received more than a liter of blood red cells per square meter, regardless of their diagnosis or ITR, are at risk of iron overload and should be screened carefully.
authors.affiliation: Department of Paediatric Haematology and Oncology, Cliniques universitaires Saint-Luc, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium.
authors.forename: Maëlle
authors.initials: M
authors.lastname: de Ville de Goyet
authors.forename: Stéphane
authors.initials: S
authors.lastname: Moniotte
authors.forename: Annie
authors.initials: A
authors.lastname: Robert
authors.forename: Sophie
authors.initials: S
authors.lastname: Dupont
authors.forename: Christiane
authors.initials: C
authors.lastname: Vermylen
authors.forename: Francis
authors.initials: F
authors.lastname: Veyckemans
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Brichard
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007223:Infant; D019190:Iron Overload / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D011446:Prospective Studies; D065227:Transfusion Reaction
chemical_list: D005293:Ferritins
keywords: blood transfusion; childhood cancer; heart disease; iron overload; liver disease; long-term effects