Dergiler / Turkish Journal of Hematology / 2020 / Cilt: 37 - Sayı: 4

Evaluation of Liver Iron Content by Magnetic Resonance Imaging in Children with Acute Lymphoblastic Leukemia after Cessation of Treatment

Tedavisi Tamamlanmış Akut Lenfoblastik Lösemili Çocuklarda Manyetik Rezonans Görüntüleme ile Karaciğer Demir İçeriğinin Değerlendirilmesi

Sayfa
263–270
DOI
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

These findings support that SF and transfusionhistory may be used as references for monitoring iron accumulationor identifying cases for further examinations such as MRI.

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Amaç & Hipotez:Objective: There are a limited number of studies evaluating ironoverload in childhood leukemia by magnetic resonance imaging(MRI).
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Temel Bulgular & Veri:The aim of this study was to determine liver iron content (LIC)by MRI in children with acute lymphoblastic leukemia (ALL) who hadcompleted treatment and to compare those values with serum ironparameters.Materials and Methods: A total of 30 patients between the ages of 7and 18 who had completed ALL treatment were included in the study.Serum iron parameters (serum iron, serum ferritin [SF], and total ironbinding capacity) and liver function tests were studied.
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Sonuç & Katkı:These findings support that SF and transfusionhistory may be used as references for monitoring iron accumulationor identifying cases for further examinations such as MRI.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

Objective: There are a limited number of studies evaluating ironoverload in childhood leukemia by magnetic resonance imaging(MRI). The aim of this study was to determine liver iron content (LIC)by MRI in children with acute lymphoblastic leukemia (ALL) who hadcompleted treatment and to compare those values with serum ironparameters.Materials and Methods: A total of 30 patients between the ages of 7and 18 who had completed ALL treatment were included in the study.Serum iron parameters (serum iron, serum ferritin [SF], and total ironbinding capacity) and liver function tests were studied. R2 MRI wasperformed for determining LIC.Results: Normal LIC was detected in 22 (63.4%) of the cases. Seven(23.3%) had mild and 1 (3.3%) had moderate liver iron deposition. Incontrast, severe iron overload was not detected in any of the cases.LIC levels were correlated with the numbers of packed red blood cell(pRBC) transfusions (r=0.637, p<0.001), pRBC transfusion volume(r=0.449, p<0.013), SF levels (r=0.561, p=0.001), and transferrinsaturation (r=0.353, p=0.044). In addition, a positive correlationwas found between the number of pRBC transfusions and SF levels(r=0.595, p<0.001).Conclusion: We showed that the frequency of liver iron depositionwas low and clinically less significant after the end of treatment inchildhood ALL patients. LIC was demonstrated to be related to SF andtransfusion history. These findings support that SF and transfusionhistory may be used as references for monitoring iron accumulationor identifying cases for further examinations such as MRI.

Abstract

Amaç: Çocukluk çağı lösemisinde aşırı demir yükünü manyetik rezonans görüntüleme (MRG) ile değerlendiren sınırlı sayıda çalışma vardır. Bu çalışmanın amacı, akut lenfoblastik lösemisi (ALL) olan ve tedavisini tamamlamış olan çocuklarda R2 MRI yöntemiyle karaciğer demir içeriğini (LIC) belirlemek ve serum demir parametreleriyle karşılaştırmaktır. Gereç ve Yöntemler: Çalışmaya ALL tedavisini tamamlayan 7-18 yaşları arasında toplam 30 hasta alındı. Serum demir parametreleri (serum demir, serum ferritin [SF] ve toplam demir bağlama kapasitesi), karaciğer fonksiyon testleri çalışıldı. LIC’yi belirlemek için R2 MRG yöntemi kullanıldı. Bulgular: Olguların 22’sinde (%63,4) normal LIC saptandı. Yedi (%23,3) olguda hafif ve 1 (%3,3) olguda orta derecede karaciğerde demir birikimi mevcuttu. Buna karşılık, hiçbir olguda ciddi derecede demir birikimi tespit edilmedi. LIC seviyeleri, pRBC transfüzyonu sayısı (r=0,637, p<0,001), pRBC transfüzyon miktarı (r=0,449, p<0,013), SF seviyeleri (r=0,561, p=0,001) ve transferrin (r=0,353, p=0,044) ile korele saptandı. Ek olarak, pRBC transfüzyonlarının sayısı ile SF seviyeleri arasında pozitif korelasyon bulundu (r=0,595, p<0,001). Sonuç: Çocukluk çağı ALL hastalarında tedavi bitiminden sonra karaciğer demir birikiminin sıklığının düşük ve klinik olarak daha az önemli olduğunu gösterdik. Ayrıca, LIC’nin SF ve transfüzyon öyküsü ile ilişkili olduğunu gösterdik. Bu bulgular, SF ve transfüzyon geçmişinin demir birikimini izlemek veya MRG gibi ileri tetkikin gerekli olduğu olguları belirlemek açısından referans olarak kullanılabileceğini desteklemektedir.

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Bu Makaleye Atıf Yap

ACAR, S., GÖZMEN, S., BAYRAKTAROĞLU, S., ACAR, S. O., TAHTA, N., AYDINOK, Y., VERGİN, R. C. (2020). Evaluation of Liver Iron Content by Magnetic Resonance Imaging in Children with Acute Lymphoblastic Leukemia after Cessation of Treatment. Turkish Journal of Hematology, Cilt: 37 - Sayı: 4, 263–270. https://ajindex.com/articles/411532

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