Hematolojik Neoplazilerde Tanı Anında Serum Demir Testlerinin Değerlendirilmesi

Abstract

The iron overload and its clinical associations in hematological neoplasias other than myelodysplastic syndrome (MDS) were studied poor. In this study, we aimed to determine the serum iron test status and the frequency of iron overload pattern at the time of diagnosis of the hematological neoplasia. Also, the iron overload pattern and its clinical associations and prognostic value were evaluated in the multiple myeloma (MM) patients who showed iron overload pattern at the time of diagnosis. The patients with acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), chronic myeloid leukemia (CML), chronic lymphoblastic leukemia (CLL), MM, MDS, Hodgkin lymphoma (HL), or Non-Hodgkin lymphoma (NHL) who applied to the Hematology unit in the last 13 years were screened in order to find cases with available serum iron tests at the diagnosis. Patients were classified as pure iron deficiency, pure inflammation pattern, iron deficiency-inflammation indiscernable, iron overload pattern, nonspecific iron test abnormality and no abnormality as their iron test patterns. Chi-square test was used to compare the frequencies of serum iron test abnormalities in hematologic neoplasia and Kaplan-Meier method was used for survival analyses. The iron test abnormalities were very frequent in hematological neoplasia at the time of diagnosis. There was at least one serum iron test abnormality in 314 of 376 patients and 61.4 % of these abnormalities could be classified. Iron overload pattern was frequent in MDS (53.3 %), AML (53.4 %), ALL (60 %) and MM (18.9 %) patients. MM patients were evaluated in detail. In these patients, iron overload pattern showed important clinical associations. Close association was seen with iron overload pattern and lambda light chain type MM. Also, more advanced stage disease was seen in the MM patients who showed iron overload pattern, and a positive correlation between disease activity and iron overload pattern was determined. It?s thought that the relationship between iron overload pattern and clinical status in hematologic malignancies other than MM should also be studied. The iron overload pattern at the time of diagnosis may emerge as an important prognostic factor and also may show a guide to treatment decision.