Pediatric blood & cancer · 2026
Transfusional Iron Overload in Children With Leukemia.
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Karadaş Nihal, Dolapçi Erkam, Gadashova Ayshe, Aydinok Yeşim, Bayraktaroğlu Selen, Yilmaz Karapinar Deniz
Аннотация
INTRODUCTION: This study examines iron overload and assesses the safety and efficacy of chelation therapy in patients with leukemia.
METHODS: The medical records of 208 children with acute leukemia were retrospectively screened. The iron status at diagnosis, cumulative packed red blood cell (pRBC) volume, number of pRBC transfusions, and iron burden of the patients at the end of intravenous chemotherapy were compared between patients who were and were not given iron chelation treatment with deferasirox.
RESULTS: A total of 193 patients with leukemia were enrolled in the study. The average age was 65.5 months, and 56% were male. The patients were grouped according to receiving chelation therapy. Forty-four patients (22.8%) received iron chelation therapy. High-risk patients needed significantly more chelation treatment (p < 0.001). The number of pRBC transfusions, cumulative pRBC volumes, and ferritin values at the beginning of maintenance therapy were significantly higher in patients who received chelation treatment (p < 0.001). The cut-off values for the predictivity of serum ferritin, cumulative pRBC volume, and number of pRBC transfusions in chelation need were determined as 1952 mcg/L, 145 mL/kg, and 12 times, respectively (0.933, 95% confidence interval [CI]: [0.887-0.964], p < 0.001; 0.942, 95% CI: [0.899-0.970], p < 0.001; 0.903, 95% CI: [0.853-0.941], p < 0.001, respectively). Deferasirox was effective and safe in reducing iron burden. Only mild-to-moderate adverse effects were observed.
CONCLUSION: Iron overload can develop in pediatric patients with leukemia and is associated with number of pRBC transfusions and cumulative pRBC transfusional volume.
METHODS: The medical records of 208 children with acute leukemia were retrospectively screened. The iron status at diagnosis, cumulative packed red blood cell (pRBC) volume, number of pRBC transfusions, and iron burden of the patients at the end of intravenous chemotherapy were compared between patients who were and were not given iron chelation treatment with deferasirox.
RESULTS: A total of 193 patients with leukemia were enrolled in the study. The average age was 65.5 months, and 56% were male. The patients were grouped according to receiving chelation therapy. Forty-four patients (22.8%) received iron chelation therapy. High-risk patients needed significantly more chelation treatment (p < 0.001). The number of pRBC transfusions, cumulative pRBC volumes, and ferritin values at the beginning of maintenance therapy were significantly higher in patients who received chelation treatment (p < 0.001). The cut-off values for the predictivity of serum ferritin, cumulative pRBC volume, and number of pRBC transfusions in chelation need were determined as 1952 mcg/L, 145 mL/kg, and 12 times, respectively (0.933, 95% confidence interval [CI]: [0.887-0.964], p < 0.001; 0.942, 95% CI: [0.899-0.970], p < 0.001; 0.903, 95% CI: [0.853-0.941], p < 0.001, respectively). Deferasirox was effective and safe in reducing iron burden. Only mild-to-moderate adverse effects were observed.
CONCLUSION: Iron overload can develop in pediatric patients with leukemia and is associated with number of pRBC transfusions and cumulative pRBC transfusional volume.