Evaluation of iron stores in acute lymphoplastic leukemia in children

ABSTRACT

Ineffective erythropoiesis and abnormal iron utilization had been noted in the development of anaemia in leukemic patients. Although serum ferritin is a valuable measurement for iron stores, yet it could not be used in disorders which are accompanied by abnormal increase in serum ferritin as in cases of acute leukemia and malignant lymphoma, and these disorders are better evaluated by iron staining in bone marrow biopsies. This rock is a trial to evaluate abnormalities of iron metabolism in acute lymphoblastic leukemia in children, and to study the possible utility of silver stain for bone marrow sideroblasts comparing to the pearl's reaction especially when the iron stores of the marrow ar elbow or absent. 20 cases of acute lymphoblastic leukemia in the acute phase, mean age [8.1 +/- 4.2] years. Were subjected to [1] thorough history and clinical examination. All cases were subjected to these investigations before taking chemotherapy [1] complete blood picture and blood indices [2] Serum iron and unsaturated iron binding capacity [3] Total iron binding capacity and transferrin saturation [4] Bone marrow aspiration and trephine biopsy and staining the specimens by pearl's reaction [Prussian blue] and modified silver stain. Our results showed a highly significant statistical difference in all cases versus the control group A progressive decrease in the mean value of haemoglobin and packed call volume with P < 0.001. The MCV, MCH and MCHC were within normal levels. Increase in serum iron and transferrin saturation in the leukemic children with P < 0.001. Decrease in TIBC with [P < 0.01] in all children. The sensitivity of the modified silver staining method in detecting iron stores in the marrow of all patients was 95% in biopsy sections and the efficacy was 100% compared to the Pearl's stain, the sensitivity was 89% and the efficacy was 90%. The silver stain was proved to be more efficient