Transfusions of packed red blood cells (PRBCs), given due to an oncological disease and its acute complications, are an indispensable part of anticancer therapy. However, they can lead to post-transfusion iron overload. The study aim was to evaluate the role of ferritin as a nonspecific marker of leukemic growth and marker of transfusion-related iron overload. We performed a longitudinal study of PRBC transfusions and changes in ferritin concentrations during the oncological treatment of 135 patients with childhood acute lymphoblastic and acute myeloblastic leukemia (ALL and AML, median age 5.62 years). At the diagnosis, 41% of patients had a ferritin level over 500 ng/mL, and 14% of patients had a ferritin level over 1000 ng/mL. At the cessation of the treatment, 80% of the children had serum ferritin (SF) over 500 ng/mL, and 31% had SF over 1000 ng/mL. There was no significant difference between SF at the beginning of the treatment between ALL and AML patients, but children with AML finished treatment with statistically higher SF. AML patients had also statistically higher number of transfusions. We found statistically significant positive correlations between ferritin and age, and weight and units of transfused blood. Serum ferritin at the moment of diagnosis can be a useful marker of leukemic growth, but high levels of SF are connected with iron overload in both AML and ALL.
因肿瘤性疾病及其急性并发症而进行的浓缩红细胞输注是抗肿瘤治疗不可或缺的组成部分，但可能导致输血后铁过载。本研究旨在评估铁蛋白作为白血病生长的非特异性标志物及输血相关铁过载标志物的作用。我们对135例儿童急性淋巴细胞白血病和急性髓系白血病患者（中位年龄5.62岁）在肿瘤治疗期间的浓缩红细胞输注情况及铁蛋白浓度变化进行了纵向研究。诊断时，41%的患者铁蛋白水平超过500 ng/mL，14%超过1000 ng/mL。治疗结束时，80%的儿童血清铁蛋白超过500 ng/mL，31%超过1000 ng/mL。急淋与急髓患者在治疗起始时的血清铁蛋白水平无显著差异，但急髓患儿治疗结束时的血清铁蛋白在统计学上显著更高。急髓患者的输血量也显著更高。我们发现铁蛋白与年龄、体重及输血单位数均存在统计学显著的正相关。诊断时的血清铁蛋白可作为白血病生长的有效标志物，但在急髓和急淋患者中，高血清铁蛋白水平均与铁过载相关。
肿瘤(癌症)患者之家