Evaluation of Liver Iron Content by Magnetic Resonance Imaging in Children with Acute Lymphoblastic Leukemia after Cessation of Treatment

Objective: There are limited number of studies evaluating iron overload in childhood leukemia by magnetic resonance imaging (MRI). The aim of this study was to determine the liver iron content (LIC) by MRI in children with acute lymphoblastic leukemia (ALL), who had been completed treatment, and to compare with serum iron parameters.

Materials and Methods: A total of 30 patients between the ages of 7 and 18 who completed ALL treatment were included in the study. Serum iron parameters [serum iron, serum ferritin (SF), and total iron binding capacity], liver function tests were studied. R2 MRI was performed for determining LIC.

Results: Normal LIC were detected in 22 (63.4%) of the cases. Seven (23.3%) had mild and 1 (3.3%) had moderate liver iron deposition. In contrast, severe iron overload was not detected in any of the cases. LIC levels were correlated with the numbers of packet red blood cell (pRBC) transfusions (r = 0.637, p <0.001), pRBC transfusion volume (r = 0.449, p <0.013), SF levels (r = 0.561, p = 0.001), transferrin saturation (r=0.353 , p = 0.044). In addition, a positive correlation was found between the number of pRBC transfusions and SF levels (r = 0.595, p <0.001).

Conclusion: We showed that the frequency of liver iron deposition was low and clinically less significant after the end of the treatment in childhood ALL patients. LIC was demonstrated to be related with SF and transfusion history. These findings support that SF and transfusion history may be used as a reference for monitoring iron accumulation or identifying cases for further examination such as MRI.