CARDIAC AND HEPATIC IRON ASSESSMENT BY MR IMAGING IN PATIENTS WITH BETA THALASSEMIA: SINGLE CENTER EXPERIENCE
(Abstract release date: 05/19/16)
EHA Library. KARAKAS Z. 06/09/16; 135026; PB2126
Prof. Dr. ZEYNEP KARAKAS
Contributions
Contributions
Abstract
Abstract: PB2126
Type: Publication Only
Background
Cardiac and hepatic magnetic resonance imaging for iron load becomes more of an issue in patients with thalassemia. The planning of chelation therapy needs more guidance in terms of signs or markers.
Aims
The aim of the study is to assess the relationship between cardiac and hepatic magnetic resonance imaging (MRI) values with serum ferritin level, splenectomy status, and chelation therapy in patients with thalassemia major and intermedia.
Methods
A total of 117 patients (58 male, 59 female) with thalassemia major (n=90) and thalassemia intermedia (n=24) who were followed up in Istanbul Medical Faculty Thalassemia Center were enrolled in the study. Their cardiac and hepatic magnetic resonance imaging was evaluated by specialist radiologist and T2* with R2* values were calculated. The chelation therapy status and splenectomy status of patients was recorded. Patients were divided into three groups according to Cardiac T2* findings: high risk group (T2* MRI <10 ms), medium risk group (T2* MRI 10–20 ms) and low-risk group (T2* MRI >20 ms). The statistical analysis between MRI findings and chelation therapy was performed by SPSS 21 version.
Results
The mean age was 24,77±9,87 years. The mean length of disease was 21,36±10,11 years. Splenectomy was performed in 40 patients. Fifty-four patients used DFX (deferasirox), 13 patients used DFP (deferiprone), 6 patients received DFO (deferoxamine), 2 patients received DFO plus DFX, and one patient was administered DFX plus DFP. The mean level of ferritin was 2093 ±1,97 ng/ml (median 1252 ng/ml). The correlations of ferritin with MR parameters were executed and results were found as following: a weak negative correlation with Cardiac T2* values (p=0,00, r=-0,35), a strong positive correlation with Hepatic R2* and liver iron concentration (p=0,00, r=0,61; p=0,00, r=0,77 respectively). There was also weak positive correlation between ferritin and ALT and AST (p=0,00, r=0,39; p=0,00, r=0,36 respectively). The gender effect on findings was found Hepatic R2* (296,7 vs 495,8 Hz) and liver iron concentration (9,6 vs 15,8 mg/g) were significantly lower in females (p=0,00). When analyzed according to chelation therapy, there was no significant relationship apart from Hepatic T2* values which were significantly higher in patients receiving DFX (6,7 vs 3,9 ms; p=0,04). The ferritin (2291 vs 1262 ng/ml) and liver iron concentration (13,8 vs 8,7 mg/g) were significantly increased in patients with thalassemia major compared to intermedia group. The ferritin level was significantly decreased from medium risk group to low-risk group (4038 vs 1758 ng/ml; p=0,00). The liver iron concentration was significantly decreased from high risk group to low-risk group (21 vs 19 and 11 mg/g; p=0,03 and p=0,02 respectively).
Conclusion
Cardiac T2* and Hepatic R2* were better correlated with ferritin. When combined with negative correlation of ferritin with Cardiac T2* values, it may be supposed that the choice of chelation therapy may be done according to Cardiac T2* and Hepatic R2* results.
Session topic: E-poster
Keyword(s): Beta thalassemia, Chelation, Deferasirox, Deferiprone
Type: Publication Only
Background
Cardiac and hepatic magnetic resonance imaging for iron load becomes more of an issue in patients with thalassemia. The planning of chelation therapy needs more guidance in terms of signs or markers.
Aims
The aim of the study is to assess the relationship between cardiac and hepatic magnetic resonance imaging (MRI) values with serum ferritin level, splenectomy status, and chelation therapy in patients with thalassemia major and intermedia.
Methods
A total of 117 patients (58 male, 59 female) with thalassemia major (n=90) and thalassemia intermedia (n=24) who were followed up in Istanbul Medical Faculty Thalassemia Center were enrolled in the study. Their cardiac and hepatic magnetic resonance imaging was evaluated by specialist radiologist and T2* with R2* values were calculated. The chelation therapy status and splenectomy status of patients was recorded. Patients were divided into three groups according to Cardiac T2* findings: high risk group (T2* MRI <10 ms), medium risk group (T2* MRI 10–20 ms) and low-risk group (T2* MRI >20 ms). The statistical analysis between MRI findings and chelation therapy was performed by SPSS 21 version.
Results
The mean age was 24,77±9,87 years. The mean length of disease was 21,36±10,11 years. Splenectomy was performed in 40 patients. Fifty-four patients used DFX (deferasirox), 13 patients used DFP (deferiprone), 6 patients received DFO (deferoxamine), 2 patients received DFO plus DFX, and one patient was administered DFX plus DFP. The mean level of ferritin was 2093 ±1,97 ng/ml (median 1252 ng/ml). The correlations of ferritin with MR parameters were executed and results were found as following: a weak negative correlation with Cardiac T2* values (p=0,00, r=-0,35), a strong positive correlation with Hepatic R2* and liver iron concentration (p=0,00, r=0,61; p=0,00, r=0,77 respectively). There was also weak positive correlation between ferritin and ALT and AST (p=0,00, r=0,39; p=0,00, r=0,36 respectively). The gender effect on findings was found Hepatic R2* (296,7 vs 495,8 Hz) and liver iron concentration (9,6 vs 15,8 mg/g) were significantly lower in females (p=0,00). When analyzed according to chelation therapy, there was no significant relationship apart from Hepatic T2* values which were significantly higher in patients receiving DFX (6,7 vs 3,9 ms; p=0,04). The ferritin (2291 vs 1262 ng/ml) and liver iron concentration (13,8 vs 8,7 mg/g) were significantly increased in patients with thalassemia major compared to intermedia group. The ferritin level was significantly decreased from medium risk group to low-risk group (4038 vs 1758 ng/ml; p=0,00). The liver iron concentration was significantly decreased from high risk group to low-risk group (21 vs 19 and 11 mg/g; p=0,03 and p=0,02 respectively).
Conclusion
Cardiac T2* and Hepatic R2* were better correlated with ferritin. When combined with negative correlation of ferritin with Cardiac T2* values, it may be supposed that the choice of chelation therapy may be done according to Cardiac T2* and Hepatic R2* results.
Session topic: E-poster
Keyword(s): Beta thalassemia, Chelation, Deferasirox, Deferiprone
Abstract: PB2126
Type: Publication Only
Background
Cardiac and hepatic magnetic resonance imaging for iron load becomes more of an issue in patients with thalassemia. The planning of chelation therapy needs more guidance in terms of signs or markers.
Aims
The aim of the study is to assess the relationship between cardiac and hepatic magnetic resonance imaging (MRI) values with serum ferritin level, splenectomy status, and chelation therapy in patients with thalassemia major and intermedia.
Methods
A total of 117 patients (58 male, 59 female) with thalassemia major (n=90) and thalassemia intermedia (n=24) who were followed up in Istanbul Medical Faculty Thalassemia Center were enrolled in the study. Their cardiac and hepatic magnetic resonance imaging was evaluated by specialist radiologist and T2* with R2* values were calculated. The chelation therapy status and splenectomy status of patients was recorded. Patients were divided into three groups according to Cardiac T2* findings: high risk group (T2* MRI <10 ms), medium risk group (T2* MRI 10–20 ms) and low-risk group (T2* MRI >20 ms). The statistical analysis between MRI findings and chelation therapy was performed by SPSS 21 version.
Results
The mean age was 24,77±9,87 years. The mean length of disease was 21,36±10,11 years. Splenectomy was performed in 40 patients. Fifty-four patients used DFX (deferasirox), 13 patients used DFP (deferiprone), 6 patients received DFO (deferoxamine), 2 patients received DFO plus DFX, and one patient was administered DFX plus DFP. The mean level of ferritin was 2093 ±1,97 ng/ml (median 1252 ng/ml). The correlations of ferritin with MR parameters were executed and results were found as following: a weak negative correlation with Cardiac T2* values (p=0,00, r=-0,35), a strong positive correlation with Hepatic R2* and liver iron concentration (p=0,00, r=0,61; p=0,00, r=0,77 respectively). There was also weak positive correlation between ferritin and ALT and AST (p=0,00, r=0,39; p=0,00, r=0,36 respectively). The gender effect on findings was found Hepatic R2* (296,7 vs 495,8 Hz) and liver iron concentration (9,6 vs 15,8 mg/g) were significantly lower in females (p=0,00). When analyzed according to chelation therapy, there was no significant relationship apart from Hepatic T2* values which were significantly higher in patients receiving DFX (6,7 vs 3,9 ms; p=0,04). The ferritin (2291 vs 1262 ng/ml) and liver iron concentration (13,8 vs 8,7 mg/g) were significantly increased in patients with thalassemia major compared to intermedia group. The ferritin level was significantly decreased from medium risk group to low-risk group (4038 vs 1758 ng/ml; p=0,00). The liver iron concentration was significantly decreased from high risk group to low-risk group (21 vs 19 and 11 mg/g; p=0,03 and p=0,02 respectively).
Conclusion
Cardiac T2* and Hepatic R2* were better correlated with ferritin. When combined with negative correlation of ferritin with Cardiac T2* values, it may be supposed that the choice of chelation therapy may be done according to Cardiac T2* and Hepatic R2* results.
Session topic: E-poster
Keyword(s): Beta thalassemia, Chelation, Deferasirox, Deferiprone
Type: Publication Only
Background
Cardiac and hepatic magnetic resonance imaging for iron load becomes more of an issue in patients with thalassemia. The planning of chelation therapy needs more guidance in terms of signs or markers.
Aims
The aim of the study is to assess the relationship between cardiac and hepatic magnetic resonance imaging (MRI) values with serum ferritin level, splenectomy status, and chelation therapy in patients with thalassemia major and intermedia.
Methods
A total of 117 patients (58 male, 59 female) with thalassemia major (n=90) and thalassemia intermedia (n=24) who were followed up in Istanbul Medical Faculty Thalassemia Center were enrolled in the study. Their cardiac and hepatic magnetic resonance imaging was evaluated by specialist radiologist and T2* with R2* values were calculated. The chelation therapy status and splenectomy status of patients was recorded. Patients were divided into three groups according to Cardiac T2* findings: high risk group (T2* MRI <10 ms), medium risk group (T2* MRI 10–20 ms) and low-risk group (T2* MRI >20 ms). The statistical analysis between MRI findings and chelation therapy was performed by SPSS 21 version.
Results
The mean age was 24,77±9,87 years. The mean length of disease was 21,36±10,11 years. Splenectomy was performed in 40 patients. Fifty-four patients used DFX (deferasirox), 13 patients used DFP (deferiprone), 6 patients received DFO (deferoxamine), 2 patients received DFO plus DFX, and one patient was administered DFX plus DFP. The mean level of ferritin was 2093 ±1,97 ng/ml (median 1252 ng/ml). The correlations of ferritin with MR parameters were executed and results were found as following: a weak negative correlation with Cardiac T2* values (p=0,00, r=-0,35), a strong positive correlation with Hepatic R2* and liver iron concentration (p=0,00, r=0,61; p=0,00, r=0,77 respectively). There was also weak positive correlation between ferritin and ALT and AST (p=0,00, r=0,39; p=0,00, r=0,36 respectively). The gender effect on findings was found Hepatic R2* (296,7 vs 495,8 Hz) and liver iron concentration (9,6 vs 15,8 mg/g) were significantly lower in females (p=0,00). When analyzed according to chelation therapy, there was no significant relationship apart from Hepatic T2* values which were significantly higher in patients receiving DFX (6,7 vs 3,9 ms; p=0,04). The ferritin (2291 vs 1262 ng/ml) and liver iron concentration (13,8 vs 8,7 mg/g) were significantly increased in patients with thalassemia major compared to intermedia group. The ferritin level was significantly decreased from medium risk group to low-risk group (4038 vs 1758 ng/ml; p=0,00). The liver iron concentration was significantly decreased from high risk group to low-risk group (21 vs 19 and 11 mg/g; p=0,03 and p=0,02 respectively).
Conclusion
Cardiac T2* and Hepatic R2* were better correlated with ferritin. When combined with negative correlation of ferritin with Cardiac T2* values, it may be supposed that the choice of chelation therapy may be done according to Cardiac T2* and Hepatic R2* results.
Session topic: E-poster
Keyword(s): Beta thalassemia, Chelation, Deferasirox, Deferiprone
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