Iron Overload During the Treatment of Acute Leukemia: Pretransplant Transfusion Experience

Yokuş, Osman; Herek, Celalettin; Cinli, Tahir Alper; Goze, Hasan; Serin, İstemi

doi:10.2217/ijh-2021-0005

Cited by 4 publications

(6 citation statements)

References 28 publications

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“…Several studies showed the increased level of serum ferritin among patients diagnosed with leukemia during early and late stages and, after the cessation of treatment. [17][18][19][20][21][22][23] Importantly, a significant proportion of patients (33.3%) exhibited serum ferritin levels above the threshold of 1000 ng/ mL, which is considered indicative of iron overload. This observation further supports the association between leukemia and elevated ferritin levels, suggesting a dysregulation in iron metabolism during the disease course.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, certain studies have examined the correlation between erythrocyte transfusions and iron overload in patients with leukemia. Yokus et al 22 reported an increased risk of hepatic and endocrine dysfunction in children with leukemia who had received 10 or more units of red blood cell transfusions. Another study by Acar and colleagues focused on evaluating liver iron content (LIC) using MRI in children with ALL.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies showed the increased level of serum ferritin among patients diagnosed with leukemia during early and late stages and, after the cessation of treatment 17–23 . Importantly, a significant proportion of patients (33.3%) exhibited serum ferritin levels above the threshold of 1000 ng/mL, which is considered indicative of iron overload.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, certain studies have examined the correlation between erythrocyte transfusions and iron overload in patients with leukemia. Yokus et al 22 conducted a study on acute leukemia patients and found that those with high serum ferritin levels had received a higher number of erythrocyte transfusions. Similarly, Cacciotti and Athale 23 reported an increased risk of hepatic and endocrine dysfunction in children with leukemia who had received 10 or more units of red blood cell transfusions.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have primarily explored the association between the number and volume of transfusions received during treatment and the development of iron overload. Yokus et al 22 demonstrated that patients with serum ferritin levels exceeding 1000 ng/mL had received a higher number of blood transfusions. Cacciotti and Athale 23 reported an increased risk of hepatic and endocrine dysfunction in patients who received 10 or more units of red blood cells during treatment.…”

Section: Discussionmentioning

confidence: 99%

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Iron Overload in Children With Leukemia; Identification of a Cutoff Value for Serum Ferritin Level

Zekavat,

Fallah Tafti,

Bordbar

et al. 2023

Journal of Pediatric Hematology/Oncology

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Objective: To determine the prevalence of iron overload in children with acute lymphoblastic leukemia (ALL) after treatment cessation and establish a cutoff value for serum ferritin level as an indicator of iron overload. Background: Early detection and monitoring of iron overload in patients with leukemia is crucial. Methods: In this prospective cohort study, 66 pediatric patients with ALL who were treated at a tertiary referral center affiliated with Shiraz University of Medical Sciences in Shiraz, Southern Iran, were investigated from July 2020 to December 2022. Serum ferritin levels were measured 6 months after treatment completion. T2* magnetic resonance imaging of the liver and heart was done for all patients. The receiver operating characteristic curve was used to illustrate the area under the receiver operating characteristic curve to assess the diagnostic value of serum ferritin level and total transfusion volume. Results: A total of 24 patients (36.4%) had iron overload in the heart or liver based on T2 magnetic resonance imaging findings. Serum ferritin level was a highly accurate diagnostic marker for iron overload in pediatric patients with ALL, with a sensitivity of 95.8%, and specificity of 85.7% for a cutoff value of 238.5 ng/mL. Also, blood transfusion was a good predictor of iron overload a sensitivity of 75% and specificity of 81% for a cutoff value of 28.3 mL/kg. Conclusion: We identified specific cutoff values for serum ferritin and blood transfusion volume to predict iron overload with high sensitivity and specificity. These markers offer a cost-effective and accessible approach for periodic screening of iron deposition, particularly in resource-constrained settings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Iron Overload in Children With Leukemia; Identification of a Cutoff Value for Serum Ferritin Level

Zekavat,

Fallah Tafti,

Bordbar

et al. 2023

Journal of Pediatric Hematology/Oncology

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Methylenetetrahydrofolate reductase levels and gene expression in leukemia

Thabit,

Jasib,

Irhaeem

et al. 2024

Current Issues in Pharmacy and Medical Sciences

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Leukemia is a neoplastic disease that affects the proliferation of white blood cells and their progenitors. Folic acid deficiency is well-known as a risk factor for leukemia. Methylenetetrahydrofolate reductase (MTHFR) enzyme functions in the folate metabolism route, DNA synthesis and methylation processes. Numerous research has been conducted to investigate the link between MTHFR and several human illnesses, including cancer, cardiovascular disease, psychiatric disorders and neurological issues. The current study aimed to examine MTHFR levels and gene expression in patients with leukemia. The research was carried out between February and October of 2022. There were 130 subjects in total, 80 with leukemia, 45 with AML (Female = 16, Male = 26) with a mean age of (32.32±2.69), and 35 with ALL (Female = 16, Male = 19) with a mean age of (35.794±0.63). The study included 50 healthy subjects as a healthy control group (Female = 28, Male = 22), with an average age of (41.8±1.57) years. MTHFR and Folic acid were measured using ELISA, while MTHFR mRNA was assessed using qPCR in blood and plasma. Folic acid and MTHFR levels were found to be lower in patients with AML and ALL compared to controls (p <0.01). MTHFR gene expression was found to be downregulated in leukemia patients (p <0.01). The findings of the study give support for future research into the effect of folic acid level and supplementation on leukemia-associated pathological outcomes. Folic acid deficiency may affect the folate mediate-one carbon metabolism pathway, as evidenced by changes in the expression of the mRNA MTHFR gene. As a result, more research into the effects of folate status and folic acid supplementation on leukemia is needed to investigate potential therapeutic strategies.

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Ceruloplasmin and some biochemical parameters as a marker for acute myeloid leukemic patients

Mohsen,

Ali

2023

Tikrit J. Pure Sci.

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Acute myeloid leukemia is a second type of leukemia and has more effect on elder patients than adult. This research's objective was to measure the serum levels of ceruloplasmin (CP), ferritin (FR), vitamin B12 (VitB12), folic acid (FA), zinc (Zn), copper (Cu), and iron (Fe) in acute myeloid leukemic patients (AML) (before and after taking chemotherapy) and healthy control groups. In this study, about (160) blood samples (males and females) were collected from acute myeloid leukemic patients in Erbil’s Nanakali hospital and they were separated into four groups: Group 1 (G1) including (40) Apparently healthy control group, Group 2 (G2) include (40) acute myeloid leukemic patients before taking chemotherapy (new cases), Group 3 (G3) include (40) acute myeloid leukemia patients taking chemotherapy for one cycle, and Group 4 (G4) include (40) acute myeloid leukemic patients with taking chemotherapy for more than one cycle. The outcomes display a significant increase in serum concentration of ceruloplasmin, ferritin, vitamin B12, and iron in all patient groups when compared with control groups. While the serum concentration of folic acid, zinc, and copper decreased in all patient groups when compared with the healthy control group. In addition, the correlation analysis displays that there was a significant positive correlation between ceruloplasmin with ferritin, vitamin B12, and iron, on another hand have a non-significant negative correlation between ceruloplasmin with folic acid, zinc, and copper. According to the present study, there was a direct correlation between AML patients with the serum levels of CP, FR, VitB12, FA, Zn, Cu, and Fe. A high area under the curve of our data suggests that testing for (CP, FR, VitB12, FA, Cu, and Fe) could be helpful to detect AML. However, zinc is not a good biomarker for detecting AML patients.

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Iron Overload During the Treatment of Acute Leukemia: Pretransplant Transfusion Experience

Cited by 4 publications

References 28 publications

Iron Overload in Children With Leukemia; Identification of a Cutoff Value for Serum Ferritin Level

Iron Overload in Children With Leukemia; Identification of a Cutoff Value for Serum Ferritin Level

Methylenetetrahydrofolate reductase levels and gene expression in leukemia

Ceruloplasmin and some biochemical parameters as a marker for acute myeloid leukemic patients

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