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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  • 造血細胞移植後の肝障害の鑑別にMRIが有用であった輸血後鉄過剰症の2小児例

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Abstract

<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>

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