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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Iron Overload in Children with Leukemia Receiving Multiple Blood Transfusions
Manjusha Nair1, Vijayalakshmi Kuttath2, Amita Radhakrishnan Nair2
1Department of Pediatrics, Regional Cancer Center, Trivandrum, Kerala, India. Correspondence to: Dr Manjusha Nair, PRA-19, Prasanth, Pathirappally Road, Poojappura PO, Trivandrum, Kerala, India. drmanjushanair@gmail.com.
Insights
A quarter of pediatric leukemia patients experience iron overload post-treatment. High blood transfusion volumes are a key factor, necessitating monitoring for potential chelation therapy.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Chemistry
Background:
- Blood transfusions are common in pediatric leukemia treatment.
- Iron accumulation can occur due to repeated transfusions.
- Monitoring iron levels is crucial for patient outcomes.
Purpose of the Study:
- To determine the prevalence of iron overload in pediatric leukemia survivors.
- To identify factors contributing to iron overload.
- To assess the impact of transfusions on iron burden.
Main Methods:
- Serum ferritin and iron levels were measured in 66 children (age 1-14) post-leukemia treatment.
- Total blood transfusion volume was quantified for each patient.
- Transfusional iron overload was defined as serum ferritin >1000 ng/mL.
Main Results:
- 83.3% of patients received red blood cell transfusions.
- 24.2% of patients showed evidence of transfusional iron overload.
- Higher transfused volume (>100 mL/kg) and treatment intensity were significant predictors of iron overload.
Conclusions:
- Iron overload affects a significant portion of pediatric leukemia patients post-treatment.
- Monitoring iron levels is essential for these patients.
- Further follow-up is needed to guide chelation therapy decisions.
Objective:
To find out prevalence of iron overload in children with leukemia at the end of treatment, and to identify factors affecting iron overload.
Methods:
Children (age-1-14 y) treated for Leukemia of our center who completed treatment between January and August 2016 were included in the study. Serum ferritin and iron were measured at completion of treatment and total blood transfusion received throughout treatment was quantified. Serum ferritin >1000 ng/mL was considered as marker of transfusional iron overload.
Results:
Out of 66 participants, 55 (83.3%) received red cell transfusions. Average transfused volume was 48 mL/kg, and patients with high-risk leukemia received more transfusions than standard-risk patients. 16 patients (24.2%) demonstrated transfusional iron overload. Total transfused volume and treatment intensity were significant factors associated with iron overload, and total transfused volume of >100 mL/kg (approximately 10 transfusions) was the most important determinant of transfusional iron burden.
Conclusions:
One-fourth of pediatric leukemia patients demonstrated iron overload at the end of treatment. These patients need to be monitored and followed-up after treatment to assess need for later chelation therapy.
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