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.