1 INTRODUCTION
Management of hematological malignancies with chemotherapy is accompanied by myelosuppression, often necessitating blood transfusions.1 The burden of transfusion-related iron overload in childhood cancer survivors is less well researched.2 There is overlap in organ toxicity due to iron overload and late effects of cancer chemotherapy which may contribute to poor quality of life in survivors. There are no established guidelines for monitoring iron overload in pediatric cancer survivors. In addition, there is a lack of information on the utility of T2* magnetic resonance imaging (T2*MRI) vs. serum ferritin to estimate iron overload in cancer survivors.
Serum ferritin is not a reliable predictor of tissue iron stores and organ dysfunction.3 The estimation of liver iron concentration (LIC) by T2*MRI has a superior correlation with liver iron assessed with liver biopsy.4,5 T2*MRI has emerged as a superior tool for estimating tissue iron overload in patients with hemoglobinopathies.
The objective of this study was two-fold, a) to measure the prevalence of iron overload in children treated for hematological malignancies, and b) define the indication(s) for requesting T2*MRI vis a vis serum ferritin for estimating iron overload in cancer survivors.