Iron Overload in Children with Leukemia Receiving Multiple Blood Transfusions

ABSTRACT

Objective: To find out prevalence of iron overload in children with leukemia at the end oftreatment, 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 August2016 were included in the study. Serum ferritin and iron were measured at completion oftreatment and total blood transfusion received throughout treatment was quantified. Serumferritin >1000 ng/mL was considered as marker of transfusional iron overload. Results: Outof 66 participants, 55 (83.3%) received red cell transfusions. Average transfused volumewas 48 mL/kg, and patients with high-risk leukemia received more transfusions thanstandard-risk patients. 16 patients (24.2%) demonstrated transfusional iron overload. Totaltransfused volume and treatment intensity were significant factors associated with ironoverload, and total transfused volume of >100 mL/kg (approximately 10 transfusions) wasthe most important determinant of transfusional iron burden. Conclusion: One-fourth ofpediatric leukemia patients demonstrated iron overload at the end of treatment. Thesepatients need to be monitored and followed-up after treatment to assess need for laterchelation therapy.