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The relationship between iron bone marrow stores and response to treatment in pediatric acute lymphoblastic leukemia
Alireza Moafi1, Mozhdeh Ziaie, Marjan Abedi
1Departmant of Pediatrics, School of Medicine, Isfahan University of Medical Sciences Department of Biology, Faculty of Sciences, University of Isfahan Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Department of Medicine, School of Medicine, University of Pécs, Pécs, Hungary.
Insights
High bone marrow iron stores (BMIS) in children with acute lymphoblastic leukemia (ALL) do not cause the disease but are linked to a poorer treatment response and increased relapse risk. Monitoring BMIS may improve patient outcomes.
Area of Science:
- Pediatric Oncology
- Hematology
- Medical Biochemistry
Background:
- Iron accumulation in the body can lead to tissue damage.
- Understanding the role of iron in pediatric acute lymphoblastic leukemia (ALL) is crucial for treatment optimization.
Purpose of the Study:
- To investigate the impact of bone marrow iron stores (BMIS) on treatment response and survival in pediatric ALL.
- To determine the relationship between BMIS and minimal residual disease in children undergoing ALL treatment.
Main Methods:
- Evaluation of bone marrow iron stores (BMIS) in 93 pediatric ALL patients after one year of treatment.
- Comparison of BMIS in ALL patients with healthy controls.
- Assessment of 3-year disease-free survival (3-DFS) and correlation with BMIS levels.
Main Results:
- BMIS levels did not significantly differ between ALL patients and controls.
- Increased BMIS was observed in 26.6% of ALL patients after one year of therapy.
- Higher BMIS correlated with increased drug resistance and bone marrow relapses in both Pre-B and T-cell ALL subtypes.
Conclusions:
- Bone marrow iron store is not a risk factor for developing childhood ALL.
- Elevated BMIS during treatment is associated with a poor response and higher risk of relapse.
- Controlling BMIS during therapy could enhance treatment efficacy and improve recovery rates in pediatric ALL.
Abstract:
Iron is an intracellular element whose accumulation in the body is associated with tissue damage. This study examines the effect of iron on pediatric acute lymphoblastic leukemia (ALL) and its "response to treatment." At the end of the first year of treatment, bone marrow iron store (BMIS) was evaluated in children with ALL and the relationship between iron store and minimal residual disease was investigated. Moreover, the 3-year disease-free survival (3-DFS) of patients was determined. Patients' BMIS were compared with that of subjects with normal bone marrow. The study examined 93 children, including 78 Pre-B and 15 T-cell ALL patients. BMIS did not differ between the children with ALL and those with no evidence of cancer. BMIS was increased in 26.6% of patients at the end of the first year of treatment. Drug resistance and BM relapses were more prevalent in cases with high BMIS in both Pre-B and T-cell groups. Bone marrow iron store is not considered a risk factor for childhood ALL. However, high levels of BMIS are associated with poor response to treatment and the risk of relapse. Bone marrow iron store control during treatment can therefore help achieve better outcomes and improve the chances of recovery.
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