Serum Iron as an independent predictor of Survival in Childhood Acute Leukemia

Abstract

The present investigation was motivated from the consideration that a host environment rich in iron, might offer favorable growth conditions for leukemic cells in addition to infection, thus affecting survival. Hypothesizing that any effect of an increased serum iron on the risk of bacterial infection would be particularly important in immunosuppressed patients during chemotherapy. Serum iron measurments were obtained on fifty – eight (58) pediatric patients with acute Lymphocytic Leukemia (ALL) before and after chemotherapy and after achieving clinical remission. The relationship between serum iron and survival was observed when patients were stratified according to length of time from diagnosis, risk group and French – American – British (FAB) classification. A significant difference (P< 0.001) was found between the survival of patients according to whether their first measured serum iron was greater than 165 µg/dL or less than 165 µg/dL, with no deaths in the group with serum iron less than 65µg/dL. It is suggested that infectious complications (pneumonia , sepsis, etc..), FAB classification should be taken into consideration in evaluating serum iron levels as prognostic variable in survival of acute lymphocytic leukemia; however, these findings suggest the need for a prospective study.