Transfusional Iron Overload in Children With Leukemia.

Area of Science:

• Hematology
• Pediatric Oncology
• Pharmacology

Background:

• Iron overload is a significant concern in pediatric patients with leukemia.
• Chronic blood transfusions in leukemia patients can lead to excessive iron accumulation.
• Assessing iron status is crucial for managing treatment-related complications.

Purpose of the Study:

• To examine iron overload in pediatric leukemia patients.
• To evaluate the safety and efficacy of iron chelation therapy using deferasirox.
• To identify predictors for the need of chelation therapy.

Main Methods:

• Retrospective screening of medical records for 208 children with acute leukemia.
• Comparison of iron status, packed red blood cell (pRBC) volume, and transfusion history between patients receiving and not receiving deferasirox.
• Determination of cut-off values for serum ferritin, cumulative pRBC volume, and pRBC transfusion number to predict chelation need.

Main Results:

• 193 patients were included; 44 (22.8%) received iron chelation therapy.
• Patients requiring chelation had significantly higher pRBC transfusions, cumulative pRBC volumes, and ferritin levels.
• Established predictive cut-off values for serum ferritin (1952 mcg/L), cumulative pRBC volume (145 mL/kg), and pRBC transfusion number (12).
• Deferasirox demonstrated effectiveness and safety in reducing iron burden, with only mild-to-moderate adverse effects.

Conclusions:

• Iron overload is a common complication in pediatric leukemia patients.
• The number of packed red blood cell transfusions and cumulative transfusional volume are associated with iron overload.
• Iron chelation therapy with deferasirox is a safe and effective strategy for managing iron overload in this population.