Correlation of liver iron concentration determined by R2 magnetic resonance imaging with serum ferritin in patients with thalassemia intermedia

Deferasirox reduces iron overload significantly in nontransfusion-dependent thalassemia: 1-year results from a prospective, randomized, double-blind, placebo-controlled study

“…For patients with ␤-thalassemia intermedia, it has been suggested that iron chelation should be initiated if LIC exceeds 7 mg Fe/g dw. [26][27][28][29][30] However, recent data in patients with ␤-thalassemia intermedia indicated that LIC Ն 7 and Ն 6 mg Fe/g dw are associated with an increased risk of vascular and endocrine/bone morbidity, respectively. 2 Our present data indicate that chelation in NTDT patients may be initiated earlier, when LIC exceeds 5 mg Fe/g dw, without evidence of tolerability issues, with a treatment goal of preventing the accumulation of iron to toxic levels.…”

Non-transfusion-dependent thalassemias

“…However, serum ferritin levels should be interpreted with caution. 37 Although there is a positive correlation between serum ferritin level and liver iron concentration in NTDT patients, 25,42,44,47 the ratio of serum ferritin to liver iron concentration is lower than in patients with β-thalassemia major. 40,44,47,51 Therefore, spot measurements of serum ferritin level may underestimate iron overload and delay therapy in patients with NTDT if they are to be interpreted in the same way as β-thalassemia major patients.…”

“…37 Although there is a positive correlation between serum ferritin level and liver iron concentration in NTDT patients, 25,42,44,47 the ratio of serum ferritin to liver iron concentration is lower than in patients with β-thalassemia major. 40,44,47,51 Therefore, spot measurements of serum ferritin level may underestimate iron overload and delay therapy in patients with NTDT if they are to be interpreted in the same way as β-thalassemia major patients. Although current evidence suggests that patients with NTDT are less likely to develop cardiac siderosis, [50][51][52][53] cardiac magnetic resonance T2* assessment may still be warranted in older patients with high iron burden.…”

“…42 Nonetheless, iron overload in NTDT patients is a cumulative process as evident from studies documenting positive correlations between iron overload indices and advancing age. 25,41,[43][44][45] Thus, a considerable proportion of NTDT patients eventually accumulate iron to liver iron concentration thresholds of clinical significance. 25,40,42,46,47 An association between iron loading evident from longitudinal elevations in serum ferritin level and worsening of hepatic fibrosis in patients with β-thalassemia intermedia has been established.…”

Iron-based ferritin nanocore as a contrast agent

“…15,16 T 2 contrast enhancements by endogenous ferritin were used to estimate iron deposition in liver, pancreas, and spleen in healthy or diseased states. [17][18][19][20][21] The surface of the ferritin molecule can be chemically/genetically modified to impart novel functionalities including tissue targeting by conjugating with receptor specific functional groups. 13 In the present study, significantly higher R 1 and R 2 relaxivities were achieved by synthesizing iron based magnetic nanocores within the cavity of an engineered Archaeoglobus fulgidus ferritin.…”