» Articles » PMID: 34945281

Setting for "Normal" Serum Ferritin Levels in Patients with Transfusion-Dependent Thalassemia: Our Current Strategy

Overview
Journal J Clin Med
Specialty General Medicine
Date 2021 Dec 24
PMID 34945281
Citations 6
Authors
Affiliations
Soon will be listed here.
Abstract

This cross-sectional study aimed to establish the association between serum ferritin levels and organ iron overload (IO) and overall morbidity in transfusion-dependent thalassemia (TDT) patients. One hundred and three TDT patients (40.03 ± 9.15 years; 57.3% females) with serum ferritin < 2500 ng/mL were included. IO was assessed by T2* magnetic resonance imaging. Three groups were identified based on mean serum ferritin levels: <500 ng/mL (group 0; N = 32), 500-1000 ng/mL (group 1; N = 43), and 1000-2500 ng/mL (group 2; N = 28). All demographic and biochemical parameters were comparable among the three groups, with the exception of the triglycerides being significantly lower in group 0 than in group 2. No difference was found in the frequency of hepatic, endocrine, and cardiac complications. Hepatic IO was significantly less frequent in group 0 versus both groups 1 and 2. No patient with a serum ferritin level < 500 ng/mL had significant myocardial IO and alterations in the main hematological parameters. No difference in the distribution of the different chelation regimens was found. Serum ferritin < 500 ng/mL appears to be achievable and safe for several TDT patients. This target is associated with the absence of significant cardiac iron and significantly lower hepatic IO and triglycerides that are well-demonstrated markers for cardiac and liver complications.

Citing Articles

Renal Findings in Patients with Thalassemia at Abdominal Ultrasound: Should We Still Talk about "Incidentalomas"? Results of a Long-Term Follow-Up.

Fatigati C, Meloni A, Costantini S, Spasiano A, Ascione F, Cademartiri F Diagnostics (Basel). 2024; 14(18).

PMID: 39335726 PMC: 11431600. DOI: 10.3390/diagnostics14182047.


Longitudinal prospective comparison of pancreatic iron by magnetic resonance in thalassemia patients transfusion-dependent since early childhood treated with combination deferiprone-desferrioxamine vs deferiprone or deferasirox monotherapy.

Ricchi P, Meloni A, Pistoia L, Gamberini M, Cuccia L, Allo M Blood Transfus. 2023; 22(1):75-85.

PMID: 37146300 PMC: 10812892. DOI: 10.2450/BloodTransfus.485.


Optimized serum ferritin prediction of iron overload in transfusion-dependent thalassemia: likelihood ratio and age-adjustment approach.

Kurban L, Almarri B, Alshamsi M, Abdelrahman S, Alwahshi S, Alhorani Q Ann Saudi Med. 2023; 43(2):90-96.

PMID: 37031371 PMC: 10082945. DOI: 10.5144/0256-4947.2023.90.


Longitudinal study of ICET-A on glucose tolerance, insulin sensitivity and β-cell secretion in eleven β-thalassemia major patients with mild iron overload.

De Sanctis V, Soliman A, Daar S, Tzoulis P, Di Maio S, Kattamis C Acta Biomed. 2023; 94(1):e2023011.

PMID: 36786253 PMC: 9987494. DOI: 10.23750/abm.v94i1.14000.


Glucose Homeostasis and Assessment of β-Cell Function by 3-hour Oral Glucose Tolerance (OGTT) in Patients with β-Thalassemia Major with Serum Ferritin below 1,000 ng/dL: Results from a Single ICET-A Centre.

De Sanctis V, Soliman A, Daar S, Tzoulis P, Di Maio S, Kattamis C Mediterr J Hematol Infect Dis. 2023; 15(1):e2023006.

PMID: 36660350 PMC: 9833310. DOI: 10.4084/MJHID.2023.006.


References
1.
Berdoukas V, Chouliaras G, Moraitis P, Zannikos K, Berdoussi E, Ladis V . The efficacy of iron chelator regimes in reducing cardiac and hepatic iron in patients with thalassaemia major: a clinical observational study. J Cardiovasc Magn Reson. 2009; 11:20. PMC: 2713224. DOI: 10.1186/1532-429X-11-20. View

2.
. Prevention and management of osteoporosis. World Health Organ Tech Rep Ser. 2004; 921:1-164, back cover. View

3.
Pennell D, Porter J, Piga A, Lai Y, El-Beshlawy A, Belhoul K . A 1-year randomized controlled trial of deferasirox vs deferoxamine for myocardial iron removal in β-thalassemia major (CORDELIA). Blood. 2014; 123(10):1447-54. PMC: 3945858. DOI: 10.1182/blood-2013-04-497842. View

4.
Meloni A, Positano V, Pepe A, Rossi G, DellAmico M, Salvatori C . Preferential patterns of myocardial iron overload by multislice multiecho T*2 CMR in thalassemia major patients. Magn Reson Med. 2010; 64(1):211-9. DOI: 10.1002/mrm.22410. View

5.
Noetzli L, Mittelman S, Watanabe R, Coates T, Wood J . Pancreatic iron and glucose dysregulation in thalassemia major. Am J Hematol. 2011; 87(2):155-60. DOI: 10.1002/ajh.22223. View