Nair Manjusha, Kuttath Vijayalakshmi, Nair Amita Radhakrishnan, Rajeswari Binitha, Chellappan Guruprasad, Thankamony Priyakumari, Parukkutty Kusumakumary
Department of Pediatrics, Regional Cancer Center, Trivandrum, Kerala, India. Correspondence to: Dr Manjusha Nair, PRA-19, Prasanth, Pathirappally Road, Poojappura PO, Trivandrum, Kerala, India.
Department of Transfusion Medicine, Regional Cancer Center, Trivandrum, Kerala, India.
Indian Pediatr. 2018 Nov 15;55(11):962-965.
To find out prevalence of iron overload in children with leukemia at the end of treatment, and to identify factors affecting iron overload.
Children (age-1-14 y) treated for Leukemia of our center who completed treatment between January and August 2016 were included in the study. Serum ferritin and iron were measured at completion of treatment and total blood transfusion received throughout treatment was quantified. Serum ferritin >1000 ng/mL was considered as marker of transfusional iron overload.
Out of 66 participants, 55 (83.3%) received red cell transfusions. Average transfused volume was 48 mL/kg, and patients with high-risk leukemia received more transfusions than standard-risk patients. 16 patients (24.2%) demonstrated transfusional iron overload. Total transfused volume and treatment intensity were significant factors associated with iron overload, and total transfused volume of >100 mL/kg (approximately 10 transfusions) was the most important determinant of transfusional iron burden.
One-fourth of pediatric leukemia patients demonstrated iron overload at the end of treatment. These patients need to be monitored and followed-up after treatment to assess need for later chelation therapy.
了解白血病患儿治疗结束时铁过载的患病率，并确定影响铁过载的因素。
本研究纳入了2016年1月至8月在本中心完成白血病治疗的1 - 14岁儿童。在治疗结束时测量血清铁蛋白和铁，并对整个治疗过程中接受的全血输注量进行量化。血清铁蛋白>1000 ng/mL被视为输血性铁过载的标志物。
66名参与者中，55名（83.3%）接受了红细胞输血。平均输血量为48 mL/kg，高危白血病患者比标准风险患者接受的输血更多。16名患者（24.2%）出现输血性铁过载。总输血量和治疗强度是与铁过载相关的重要因素，总输血量>100 mL/kg（约10次输血）是输血性铁负荷的最重要决定因素。
四分之一的小儿白血病患者在治疗结束时出现铁过载。这些患者在治疗后需要进行监测和随访，以评估后期螯合治疗的必要性。
