Trovillion Erin Murphy, Schubert Lynn, Dietz Andrew C
Division of Pediatric Hematology/Oncology/BMT, Rady Children's Hospital, San Diego.
Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA.
J Pediatr Hematol Oncol. 2018 Jul;40(5):396-400. doi: 10.1097/MPH.0000000000000887.
BACKGROUND: Patients transfused with packed red blood cells (PRBC), including childhood cancer survivors (CCS), experience complications. We describe iron overload (ferritin>500 ng/mL) prevalence and identify risk factors in CCS. OBSERVATIONS: Of 116 participants, 3 (2.6%) had elevated ferritin. All were teenagers at cancer diagnosis and received >8000 mL PRBC. Total PRBC volume correlated best with elevated ferritin (r=0.74; P<0.0001). PRBC (8000 mL) had the best positive and negative predictive value (75% and 100%, respectively) for iron overload. CONCLUSIONS: CCS may have iron overload. Overall prevalence is low. At-risk include teenagers at diagnosis and those receiving higher total PRBC volumes.
背景：包括儿童癌症幸存者（CCS）在内的接受浓缩红细胞（PRBC）输血的患者会出现并发症。我们描述了铁过载（铁蛋白>500 ng/mL）的患病率，并确定了CCS中的风险因素。 观察结果：在116名参与者中，3人（2.6%）铁蛋白升高。所有患者在癌症诊断时均为青少年，且接受了超过8000 mL的PRBC。PRBC总量与铁蛋白升高的相关性最佳（r=0.74；P<0.0001）。PRBC（8000 mL）对铁过载具有最佳的阳性和阴性预测价值（分别为75%和100%）。 结论：CCS可能存在铁过载。总体患病率较低。有风险的人群包括诊断时为青少年以及接受PRBC总量较高的患者。
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