TWO PEDIATRIC CASES OF POST-TRANSFUSION IRON OVERLOAD IN WHICH MRI WAS USEFUL FOR DIFFERENTIATING LIVER INJURY AFTER HEMATOPOIETIC CELL TRANSPLANTATION

Washio Kana, Shiwaku Takahiro, Tamefusa Kosuke, Ochi Motoharu, Ishida Hisashi, Kanamitsu Kiichiro, Fujiwara Kaori, Tsukahara Hirokazu

doi:10.3925/jjtc.69.605

<p>There have been several reports from other countries regarding post-transfusion iron overload in pediatric patients with cancer. Similar to adults, a correlation between pre-transplantation ferritin levels and complications in pediatric patients receiving allogeneic hematopoietic cell transplantation has been reported overseas, but not in Japan. We experienced two cases of liver injury in which MRI was useful in discriminating between post-transfusion iron overload and hepatic graft versus host disease (GVHD). Both patients had acute myeloid leukemia, and despite immunosuppressive therapy for hepatic GVHD, they presented with persistent liver damage and hyperferritinemia. On MRI, both had typical findings of post-transfusion iron overload. In pediatric patients with cancer who have a long myelosuppression period and require frequent blood transfusion, post-transfusion iron overload accompanied by organ damage may occur in the acute phase. A large-scale survey of this issue in Japan is required.</p>

TWO PEDIATRIC CASES OF POST-TRANSFUSION IRON OVERLOAD IN WHICH MRI WAS USEFUL FOR DIFFERENTIATING LIVER INJURY AFTER HEMATOPOIETIC CELL TRANSPLANTATION

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