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Iron deficiency in children at the time of initial neuroblastoma diagnosis
Hongjun Fan1, Yan Su1, Chao Duan1
1Beijing Key Laboratory of Pediatric Hematology Oncology National Discipline of Pediatrics Ministry of Education MOE Key Laboratory of Major Diseases in Children Hematology Oncology Center Beijing Children's Hospital Capital Medical University National Center for Children's Health Beijing China.
Insights
Iron deficiency is common in children, and this study found it affects over 60% of neuroblastoma patients. Functional iron deficiency at diagnosis predicts poorer outcomes in these young cancer patients.
Area of Science:
- Pediatric Oncology
- Hematology
- Nutritional Science
Background:
- Iron deficiency is a global health concern in children, often leading to anemia.
- Its prevalence and specific types in neuroblastoma patients remain understudied.
- Neuroblastoma is a common childhood cancer with significant treatment challenges.
Purpose of the Study:
- To determine the prevalence of iron deficiency in newly diagnosed neuroblastoma patients.
- To identify different types of iron deficiency (absolute and functional) in this cohort.
- To explore associations between iron deficiency and clinical characteristics.
Main Methods:
- Retrospective analysis of 195 newly diagnosed neuroblastoma patients (November 2015 - January 2018).
- Assessment of iron deficiency status, including absolute and functional types.
- Kaplan-Meier method used for survival analysis.
Main Results:
- Over 62% of neuroblastoma patients (121/195) had iron deficiency.
- Functional iron deficiency was present in 33.9% (66/195) of patients.
- Factors like age, tumor location, high-risk status, and specific biomarkers were linked to higher rates of functional iron deficiency.
Conclusions:
- Functional iron deficiency at diagnosis is a predictor of lower event-free survival in neuroblastoma.
- Further research is needed on the long-term impact of iron supplementation for neuroblastoma patients with various iron deficiency types.
Importance:
There is a high incidence of iron deficiency in children worldwide. Notably, however, while iron deficiency is the most common cause of anemia, little is known about the prevalence and different types of iron deficiency in neuroblastoma patients.
Objective:
The aim of the present study was to investigate the prevalence of iron deficiency in patients newly diagnosed with neuroblastoma.
Methods:
A total of 195 newly diagnosed neuroblastoma patients from November 2015 to January 2018 were analyzed retrospectively. The survival analysis was estimated by the Kaplan-Meier method.
Results:
Of the 195 neuroblastoma patients included in the study, 121 (62.1%) had iron deficiency, 55 (28.2%) had absolute iron deficiency, and 66 (33.9%) had functional iron deficiency. Being aged ≥ 18 months, tumor originating in the abdomen, International Neuroblastoma Risk Group Staging System M, high-risk neuroblastoma, lactate dehydrogenase ≥ 1500 U/L, neuron-specific enolase ≥ 100 U/L, unfavorable histologic category, MYCN amplification, chromosome 1p loss, and bone marrow metastasis were associated with significantly higher rates of functional iron deficiency (P < 0.05).
Interpretation:
Functional iron deficiency at the time of initial neuroblastoma diagnosis predicted lower event-free survival. Long-term effects of iron supplementation in neuroblastoma patients with different types of iron deficiency need to be further studied.
