Transfusional hemosiderosis in childhood cancer patients and survivors

被引:0
作者
Baskin-Miller, Jacquelyn [1 ]
Carson, Susan [2 ]
Jaffray, Julie [3 ]
Fletcher, Craig [4 ]
Singer, Jessie [4 ]
Freyer, David R. [2 ]
Wood, John [5 ]
Coates, Thomas D. [2 ]
Denton, Christopher C. [2 ]
机构
[1] Univ N Carolina, Sch Med, Div Pediat Hematol Oncol, Chapel Hill, NC 28223 USA
[2] Childrens Hosp Los Angeles, Childrens Ctr Canc, Blood Dis & Bone Marrow Transplantat, Los Angeles, CA USA
[3] Rady Childrens Hosp, Div Pediat Hematol Oncol, San Diego, CA USA
[4] Childrens Hosp Angeles, Dept Pathol & Lab Med, Los Angeles, CA USA
[5] Childrens Hosp Los Angeles, Div Cardiol, Los Angeles, CA USA
关键词
childhood cancer; iron overload; THALASSEMIA MAJOR PATIENTS; HEPATIC IRON CONCENTRATION; TRANSFERRIN-BOUND IRON; TOTAL-BODY IRON; DEPENDENT THALASSEMIA; PITUITARY IRON; OVERLOAD; CHILDREN; DISEASE; BURDEN;
D O I
10.1002/pbc.31220
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundChildren treated for cancer are at risk for adverse effects of iron due to transfusions administered during prolonged marrow suppression, which may increase exposure to toxic forms of iron, extrahepatic iron accumulation, and long-term organ damage.ObjectiveThis study aimed to characterize the severity and organ distribution of clinically significant, multisystem iron overload (IO) in an at-risk cohort of pediatric cancer patients.MethodsThis was a retrospective, cross-sectional study of childhood cancer patients who underwent a magnetic resonance imaging (MRI) due to clinical concern for IO. Data regarding cancer type and treatment, transfusion history, MRI and laboratory results, and treatment for IO were collected. Severity of IO was analyzed by non-parametric tests with respect to clinical characteristics.ResultsOf the 103 patients, 98% of whom had a Cancer Intensity Treatment Rating (ITR-3) of 3 or higher, 53% (54/102) had moderate or greater hepatic siderosis, 80% (77/96) had pancreatic siderosis, 4% (3/80) had cardiac siderosis, and 45% (13/29) had pituitary siderosis and/or volume loss. Pancreatic iron was associated with both cardiac (p = .0043) and pituitary iron (p = .0101). In the 73 off-therapy patients, ferritin levels were lower (p = .0008) with higher correlation with liver iron concentration (LIC) (p = .0016) than on-therapy patients. Fifty-eight subjects were treated for IO.ConclusionIn this heavily treated cohort of pediatric cancer patients, more than 80% had extrahepatic iron loading, which occurs with significant exposure to toxic forms of iron related to decreased marrow activity in setting of transfusions. Further studies should examine the effects of exposure to reactive iron on long-term outcomes and potential strategies for management.
引用
收藏
页数:9
相关论文
共 50 条
  • [41] Endocrine dysfunction in childhood cancer survivors
    Armougon, Aurelie
    Castanet, Mireille
    CORRESPONDANCES EN METABOLISMES HORMONES DIABETES ET NUTRITION, 2011, 15 (07): : 220 - 227
  • [42] Endocrine Sequelae in Childhood Cancer Survivors
    George, Sobenna A.
    Effinger, Karen E.
    Meacham, Lillian R.
    ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA, 2020, 49 (04) : 565 - +
  • [43] Thyroid Abnormalities in Survivors of Childhood Cancer
    Caglar, Ayla Akca
    Oguz, Aynur
    Pinarli, Faruk Guclu
    Karadeniz, Ceyda
    Okur, Arzu
    Bideci, Aysun
    Kocak, Ulker
    Bora, Huseyin
    JOURNAL OF CLINICAL RESEARCH IN PEDIATRIC ENDOCRINOLOGY, 2014, 6 (03) : 144 - 151
  • [44] Obesity in Survivors of Childhood Cancer: a Review
    Carneiro Teixeira, Julia Ferrari
    Maia-Lemos, Priscila dos Santos
    Cypriano, Monica dos Santos
    Pisani, Luciana Pellegrini
    PEDIATRIC ENDOCRINOLOGY REVIEWS PER, 2017, 15 (01) : 33 - 39
  • [45] Risk Factors and Dental Caries Incidence in Childhood Cancer Survivors
    Jodlowska, Anna
    Ilczuk-Rypula, Danuta
    CANCERS, 2025, 17 (06)
  • [46] Parental smoking and respiratory outcomes in young childhood cancer survivors
    Zarkovic, Masa
    Sommer, Grit
    Nigg, Carina
    Slama, Tomas
    Schneider, Christine
    Ansari, Marc
    von Der Weid, Nicolas
    Schindera, Christina
    Kuehni, Claudia E.
    PEDIATRIC BLOOD & CANCER, 2024,
  • [47] Parenting stress and neurocognitive late effects in childhood cancer survivors
    Patel, Sunita K.
    Wong, Andrew L.
    Cuevas, Michelle
    Van Horn, Hillary
    PSYCHO-ONCOLOGY, 2013, 22 (08) : 1774 - 1782
  • [48] Cardiac or cardiopulmonary transplantation in childhood cancer survivors: An increasing need?
    Levitt, Gill
    Anazodo, Antoinette
    Burch, Michael
    Bunch, Kathryn
    EUROPEAN JOURNAL OF CANCER, 2009, 45 (17) : 3027 - 3034
  • [49] Transfusion-Related Iron Overload in Childhood Cancer Survivors
    Khattachan, O.
    Chiengthong, K.
    Lauhasurayothin, S.
    Sosothikul, D.
    Techavichit, P.
    PEDIATRIC BLOOD & CANCER, 2018, 65 : S687 - S687
  • [50] High Risk of Symptomatic Cardiac Events in Childhood Cancer Survivors
    van der Pal, Helena J.
    van Dalen, Elvira C.
    van Delden, Evelien
    van Dijk, Irma W.
    Kok, Wouter E.
    Geskus, Ronald B.
    Sieswerda, Elske
    Oldenburger, Foppe
    Koning, Caro C.
    van Leeuwen, Flora E.
    Caron, Huib N.
    Kremer, Leontien C.
    JOURNAL OF CLINICAL ONCOLOGY, 2012, 30 (13) : 1429 - 1437