Aysu İLHAN YALAKİ, Begül YAĞCI KÜPELİ, Serhan KÜPELİ, İbrahim BAYRAM, Okan DİLEK, Cengiz YILMAZ

Çocukluk çağı kanserlerinde transfüzyon ile ilişkili aşırı demir yükü

Amaç: Bu çalışmada kanser tedavisini tamamlamış çocuklarda demir yükünü ve olası hedef organ hasarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Kanser tedavisinin tamamlanması üzerinden en az 6 ay geçmiş olan hastaların dosyaları tedavi süresi, tedavi kesildikten sonra geçen süre, nüks durumu, tedavi sırasında verilen eritrosit süspansiyonu sayısı, karaciğer fonksiyon testleri, ferritin düzeyi, T2*Manyetik Rezonans Görüntüleme (MRG) bulguları yönünden retrospektif olarak değerlendirildi. Bulgular: Solid tümör ve hematolojik malignite tanılı 118 hasta çalışmaya dahil edildi. Hastaların 44’ü (%37,2) kız, 74’ü (%62,8) erkek idi. Ortalama yaş 10,71±4,64 yıldı, Ferritin düzeyleri ile tedavi kesildikten sonra geçen süre arasında negatif yönde zayıf korelasyon saptandı. Tedavi süresince verilen eritrosit süspansiyonu sayısı ile ferritin düzeyleri arasında pozitif yönde zayıf korelasyon saptandı. Ferritin düzeyi nüks olan hastalarda (9/118) olmayanlara (109/118) göre istatistiksel olarak anlamlı şekilde yüksek bulundu.Sonuç: Demir yükünün değerlendirilmesi amacıyla bakılan ferritin düzeyleri tedavi sırasında daha sık transfüzyon yapılan hastalarda daha yüksek bulunmuştur. Bununla birlikte, T2*MRG ile karaciğerde anormal demir birikimi tespit edilmemiştir.

Anahtar Kelimeler:

Demir yükü, çocukluk çağı kanserleri, ferritin, T2*MRG

Transfusion associated iron overload in childhood cancer survivors

Purpose: We aimed to evaluate iron burden and possible target organ damage in childhood cancer survivorsMaterials and Methods: Files of patients treated for cancer and completed treatment at least 6 months ago were retrospectively evaluated for treatment duration, duration after cessation of treatment, relapse status, erythrocyte transfusion number given during treatment, liver function tests, ferritin levels, T*2 Magnetic resonance imaging (MRI) results. Results: 118 patients with solid tumors and hematological malignancies were included in the study. There were 44 (37.2%) female, 74 (62.8%) male patients with a mean age of 10.71 ± 4.64 years. There was a weak negative correlation between time after cessation of treatment and ferritin levels. A statistically significant weak positive correlation between ferritin levels and number of erythrocyte transfusions were. Ferritin levels were significantly higher in patients who had relapse (9/118) compared to patients with no relapse (109/118).Conclusion: Transfusion associated iron overload measured by ferritin level was higher patients who were more frequently transfused during treatment. However, abnormal iron accumulation in liver was not detected using qualitative analysis with T*2 MRI method.

Keywords:

Iron overload, childhood cancer, ferritin, T2*MRI,

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