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Previous Volume 343:327-331 August 3, 2000 Number 5 Next

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ABSTRACT

Background and Methods We tested the usefulness of measuring the hepatic iron concentration to evaluate total body iron stores in patients who had been cured of thalassemia major by bone marrow transplantation and who were undergoing phlebotomy treatment to remove excess iron.

Results We began treatment with phlebotomy a mean (±SD) of 4.3±2.7 years after transplantation in 48 patients without hepatic cirrhosis. In the group of 25 patients with liver-biopsy samples that were at least 1.0 mg in dry weight, there was a significant correlation between the decrease in the hepatic iron concentration and total body iron stores (r=0.98, P<0.001). Assuming that the hepatic iron concentration is reduced to zero with complete removal of body iron stores during phlebotomy, the amount of total body iron stores (in milligrams per kilogram of body weight) is equivalent to 10.6 times the hepatic iron concentration (in milligrams per gram of liver, dry weight). With the use of this equation, we could reliably estimate total body iron stores as high as 250 mg per kilogram of body weight, with a standard error of less than 7.9.

Conclusions The hepatic iron concentration is a reliable indicator of total body iron stores in patients with thalassemia major. In patients with transfusion-related iron overload, repeated determinations of the hepatic iron concentration can provide a quantitative means of measuring the long-term iron balance.

Source Information

From the Unità Operativa di Ematologia e Centro Trapianto Midollo Osseo di Muraglia, Azienda Ospedale di Pesaro, Pesaro, Italy (E.A., M.R., D.B., C.G., M.G., P.P., G.L.); the Departments of Pediatrics and Medicine, Columbia University College of Physicians and Surgeons, New York (G.M.B.); and the Division of Epidemiology, Department of Medicine, University of California, Irvine, Calif. (C.E.M.).

Address reprint requests to Dr. Angelucci at Unità Operativa di Ematologia di Muraglia, Azienda Ospedale di Pesaro, 61100 Pesaro, Italy, or at emnang{at}tin.it.

Full Text of this Article

Related Letters:

Hepatic Iron Concentration and Total Body Iron Stores in Thalassemia Major
Bonkovsky H. L., Davidoff A., Stark D. D., Kami M., Hamaki T., Kishi Y., Angelucci E., Brittenham G. M., Lucarelli G.
Extract | Full Text  
N Engl J Med 2000; 343:1656-1657, Nov 30, 2000. Correspondence

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