Early Cardiac Iron Overload in a Child on Treatment of Acute Lymphoblastic Leukemia.
An 11-year-old boy with Down syndrome and acute lymphoblastic leukemia developed hepatic dysfunction after only 10 months of treatment. MRI revealed severe iron deposition in the liver, pancreas, and heart. In stark contrast to what is seen in hemoglobinopathies, pancreatic and cardiac iron overload occurred with relatively low transfusion exposure and in a very short time period in this patient. Although extensive experience managing iron overload in hemoglobinopathies informs our approach in other diseases, it is clear that factors not present in hemoglobinopathies may be operative in patients with malignancy undergoing intense chemotherapy that lead to high levels of free iron and rapid loading of the heart and endocrine organs.
Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California; and.
Aaron J
AJ
Reitman
Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California; and Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California tcoates@chla.usc.edu.
Thomas D
TD
Coates
Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California; and Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California.
David R
DR
Freyer
D000970:Antineoplastic Agents / Q000009:adverse effects; D001803:Blood Transfusion; D002648:Child; D006801:Humans; D019190:Iron Overload / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D008297:Male; D009206:Myocardium / Q000378:metabolism*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood* / Q000150:complications / Q000628:therapy*; D065227:Transfusion Reaction; D016896:Treatment Outcome
D000970:Antineoplastic Agents