Contributions
Abstract: PB2498
Type: Publication Only
Background
Chronic blood transfusion cause inevitable iron overload. Conflicting results were found regarding how much serum ferritin can predict tissue iron overload among chronically transfused patients and how much it differs by age.
Aims
to evaluate cardiac (CIO) and liver Iron overload (LIO) in children with sickle cell disease (SCD) and Transfusion dependent thalassemia (TDT) and testing their predictability by using the serum ferritin trend.
Methods
3 Serum ferritin levels were tested at interval of 6 months, the last one was at the time of MRI T2* examination of both liver and heart. Increasing values of serum ferritin over time was considered an increasing trend.
Results
90 (43 male, 9.9+/_4.4 year) TDT and 47 (32 male, 11.85 +/_3.82 year) SCD children were included. LIO was higher among TDT children with liver iron concentration of 11.87 mg/g, and 6.58 mg/g (p: 0.0001). Similarly, there was a higher level of CIO in TDT (T2*: 24.38 m/sec) than in SCD (31.97 m/sec) (p: 0.001). Age didn’t increase the risk of LIO (OR 0.81, CI 0.46-1.42, p: 0.47), or CIO (OR 1.23, CI 0.74-2.03, p: 0.43) in TDT neither did of LIO (OR 1.054, CI 0.86-1.28, p: 0.61) nor CIO (OR 0.722, CI 0.41-1.28, p: 0.27) in SCD. Percentage of children with increasing trend of serum ferritin was 50 % in TDT and 30% in SCD children (p: 0.31). The relationship between serum ferritin trend and CIO/ LIO in TDT (p: 1.0/0.67) and CIO/LIO in SCD (p: 1.0/0.66) was insignificant. In TDT, Serum ferritin at a level of > 4036 µg/l could differentiate mod/severe CIO from those with none/mild one (AUC 0.872, p: 0.001). Similar discrimination could be achieved regarding LIO in TDT at a lower level of > 2294 µg/l (AUC 0.879, p: 0.001). In SCD Mod/severe LIO could be discriminated from none/mild LIO at a level of > 1892 µg/l serum ferritin (AUC 0.822, p: 0.001).
Conclusion
Serum ferritin level could predict both LIO and CIO in TDT cases, and LIO in SCD. Ferritin trend had no relation to tissue iron overload in both groups.
Session topic: 28. Thalassemias
Keyword(s): Ferritin, iron overload, Thalassemia
Abstract: PB2498
Type: Publication Only
Background
Chronic blood transfusion cause inevitable iron overload. Conflicting results were found regarding how much serum ferritin can predict tissue iron overload among chronically transfused patients and how much it differs by age.
Aims
to evaluate cardiac (CIO) and liver Iron overload (LIO) in children with sickle cell disease (SCD) and Transfusion dependent thalassemia (TDT) and testing their predictability by using the serum ferritin trend.
Methods
3 Serum ferritin levels were tested at interval of 6 months, the last one was at the time of MRI T2* examination of both liver and heart. Increasing values of serum ferritin over time was considered an increasing trend.
Results
90 (43 male, 9.9+/_4.4 year) TDT and 47 (32 male, 11.85 +/_3.82 year) SCD children were included. LIO was higher among TDT children with liver iron concentration of 11.87 mg/g, and 6.58 mg/g (p: 0.0001). Similarly, there was a higher level of CIO in TDT (T2*: 24.38 m/sec) than in SCD (31.97 m/sec) (p: 0.001). Age didn’t increase the risk of LIO (OR 0.81, CI 0.46-1.42, p: 0.47), or CIO (OR 1.23, CI 0.74-2.03, p: 0.43) in TDT neither did of LIO (OR 1.054, CI 0.86-1.28, p: 0.61) nor CIO (OR 0.722, CI 0.41-1.28, p: 0.27) in SCD. Percentage of children with increasing trend of serum ferritin was 50 % in TDT and 30% in SCD children (p: 0.31). The relationship between serum ferritin trend and CIO/ LIO in TDT (p: 1.0/0.67) and CIO/LIO in SCD (p: 1.0/0.66) was insignificant. In TDT, Serum ferritin at a level of > 4036 µg/l could differentiate mod/severe CIO from those with none/mild one (AUC 0.872, p: 0.001). Similar discrimination could be achieved regarding LIO in TDT at a lower level of > 2294 µg/l (AUC 0.879, p: 0.001). In SCD Mod/severe LIO could be discriminated from none/mild LIO at a level of > 1892 µg/l serum ferritin (AUC 0.822, p: 0.001).
Conclusion
Serum ferritin level could predict both LIO and CIO in TDT cases, and LIO in SCD. Ferritin trend had no relation to tissue iron overload in both groups.
Session topic: 28. Thalassemias
Keyword(s): Ferritin, iron overload, Thalassemia