ironjustice

Brief Report
Serum ferritin underestimates liver iron concentration in transfusion
independent thalassemia patients as compared to regularly transfused
thalassemia and sickle cell patients
Zahra Pakbaz, MD 1 *, Roland Fischer, PhD 1 2, Ellen Fung, PhD, RD 1,
Peter Nielsen, MD, PhD 2, Paul Harmatz, MD 1, Elliott Vichinsky, MD 1
1Children's Hospital & Research Center Oakland, Oakland, California
2University Medical Center Hamburg-Eppendorf, Hamburg, Germany

email: Zahra Pakbaz (zpakbaz@mail.cho.org)

*Correspondence to Zahra Pakbaz, Children's Hospital & Research Center
Oakland, 747 52nd Street, Oakland, CA 94609.

Funded by:
National Institutes of Health; Grant Number: M01RR01271

Keywords
ferritin · liver iron concentration · sickle cell · thalassemia


Abstract
Serum ferritin (SF) and liver iron concentration (LIC), as measured by
SQUID biosusceptometry, were assessed in a convenience sample of
transfusion independent thalassemia patients (nTx-Thal, n = 26),
regularly transfused thalassemia (Tx-Thal, n = 89), or sickle cell
patients (SCD, n = 45) to investigate the severity of iron overload
and the relationship between SF and LIC in nTx-Thal compared to SCD
and Tx-Thal. SF correlated with LIC (RS = 0.53, P < 0.001), but was
found to be a poor predictor for LIC. SF was significantly lower (P <
0.001) in nTx-Thal patients than in other groups, despite similar LIC
values. The SF-to-LIC ratio was significantly lower in nTx-Thal
compared to Tx-Thal and SCD patients (median of 0.32, 0.87, and 1.2,
respectively: P < 0.001). Due to underestimation of LIC by ferritin
levels, chelation treatment may be delayed or misdirected in patients
with thalassemia intermedia.
Pediatr Blood Cancer 2007;49:329-332. © 2007 Wiley-Liss, Inc.

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Received: 21 June 2006; Accepted: 26 April 2007
Digital Object Identifier (DOI)

10.1002/pbc.21275 About DOI
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