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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Serum ferritin level changes in children with sickle cell disease on chronic blood transfusion are nonlinear and are associated with iron load and liver injury
Blood, Volume 114, No. 21, Year 2009
Notification
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Description
Chronic blood transfusion is increasingly indicated in patients with sickle cell disease. Measuring resulting iron overload remains a challenge. Children without viral hepatitis enrolled in 2 trials for stroke prevention were examined for iron overload (STOP and STOP2; n = 271). Most received desferrioxamine chelation. Serum ferritin (SF) changes appeared nonlinear compared with prechelation estimated transfusion iron load (TIL) or with liver iron concentrations (LICs). Averaged correlation coefficient between SF and TIL (patients/observations, 26 of 164) was r = 0.70; between SF and LIC (patients/observations, 33 of 47) was r = 0.55. In mixed models, SF was associated with LIC (P = .006), alanine transaminase (P = .025), and weight (P = .026). Most patients with SF between 750 and 1500 ng/mL had a TIL between 25 and 100 mg/kg (72.8% ± 5.9%; patients/observations, 24 of 50) or an LIC between 2.5 and 10 mg/g dry liver weight (75% ± 0%; patients/ observations, 8 of 9). Most patients with SF of 3000 ng/mL or greater had a TIL of 100 mg/kg or greater (95.3% ± 6.7%; patients/observations, 7 of 16) or an LIC of 10 mg/g dry liver weight or greater (87.7% ± 4.3%; patients/observations, 11 of 18). Although SF changes are nonlinear, levels less than 1500 ng/mL indicated mostly acceptable iron overload; levels of 3000 ng/mL or greater were specific for significant iron overload and were associated with liver injury. However, to determine accurately iron overload in patients with intermediately elevated SF levels, other methods are required. These trials are registered at www.clinicaltrials.gov as #NCT00000592 and #NCT00006182. © 2009 by The American Society of Hematology.
Authors & Co-Authors
Adamkiewicz, Thomas V.
United States, Atlanta
Morehouse School of Medicine
Abboud, Miguel Raul
United States, Charleston
Medical University of South Carolina
Lebanon, Beirut
American University of Beirut
Paley, Carole S.
Switzerland, Basel
Novartis International ag
Olivieri, Nancy F.
Canada, Toronto
University of Toronto
Kirby-Allen, Melanie
Canada, Toronto
University of Toronto
Vichinsky, Elliott P.
United States, Oakland
Ucsf Benioff Children's Hospital Oakland
Casella, James F.
United States, Baltimore
Johns Hopkins University
Alvarez, Ofelia A.
United States, Coral Gables
University of Miami
Barredo, Julio
United States, Charleston
Medical University of South Carolina
United States, Coral Gables
University of Miami
Lee, Margaret T.
United States, New York
Columbia University
Iyer, Rathi V.
United States, Jackson
University of Mississippi Medical Center
Kutlar, Abdullah
United States, Augusta
Medical College of Georgia
McKie, Kathleen M.
United States, Augusta
Medical College of Georgia
McKie, Virgil C.
United States, Augusta
Medical College of Georgia
Odo, Nadine
United States, Augusta
Medical College of Georgia
Gee, Beatrice
United States, Atlanta
Morehouse School of Medicine
Kwiatkowski, Janet L.
United States, Philadelphia
The Children's Hospital of Philadelphia
Woods, Gerald M.
United States, Kansas City
Children's Mercy Hospitals and Clinics
Coates, Thomas D.
United States, Los Angeles
Children's Hospital Los Angeles
Wang, Winfred C.
United States, Memphis
St. Jude Children's Research Hospital
Adams, Robert J.
United States, Charleston
Medical University of South Carolina
United States, Augusta
Medical College of Georgia
Statistics
Citations: 94
Authors: 21
Affiliations: 15
Identifiers
Doi:
10.1182/blood-2009-02-203323
ISSN:
00064971
Research Areas
Infectious Diseases
Maternal And Child Health
Noncommunicable Diseases
Violence And Injury