Glycosylated ferritin as an improved marker for post-transfusion iron overload
- 5 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Journal of Hematology
- Vol. 113 (4), 537-546
- https://doi.org/10.1007/s12185-020-03056-9
Abstract
Red blood cell (RBC) transfusion is an effective therapy for anemia, but repeated transfusions may cause iron overload-related damage to various organs. Iron chelation therapy, now widely available for patients who have received transfusions, is expected to reduce organ damage even in patients who received many transfusions. Therefore, determining when to start iron chelation therapy is important. In guidelines for iron chelation therapy, the serum ferritin level has been widely accepted as a practical marker for estimating iron overload. However, guidelines recommend multiple measurements of serum ferritin, because levels often fluctuate. Here, we investigated the usefulness of glycosylated ferritin as a marker of iron overload using a cohort consisted of 103 patients who had a total ferritin value over 1000 ng/mL. We found that the volume of RBCs transfused was clearly associated with the glycosylated ferritin level. We also found that acute inflammation, as represented by C-reactive protein values, was associated with increased non-glycosylated ferritin and that patients with hematopoietic diseases had higher glycosylated ferritin levels, possibly because of repeated RBC transfusions. We thus conclude that glycosylated ferritin may be an improved marker for predicting iron overload status.Keywords
This publication has 27 references indexed in Scilit:
- Causes and Significance of Markedly Elevated Serum Ferritin Levels in an Academic Medical CenterJCR: Journal of Clinical Rheumatology, 2013
- The Hyperferritinemic Syndrome: macrophage activation syndrome, Still’s disease, septic shock and catastrophic antiphospholipid syndromeBMC Medicine, 2013
- Korean Guideline for Iron Chelation Therapy in Transfusion-Induced Iron OverloadJournal of Korean Medical Science, 2013
- Serum ferritin: Past, present and futureBiochimica et Biophysica Acta (BBA) - General Subjects, 2010
- Iron Homeostasis: Recently Identified Proteins Provide Insight into Novel Control MechanismsOnline Journal of Public Health Informatics, 2009
- Japanese epidemiological survey with consensus statement on Japanese guidelines for treatment of iron overload in bone marrow failure syndromesInternational Journal of Hematology, 2008
- Retrospective nationwide survey of Japanese patients with transfusion‐dependent MDS and aplastic anemia highlights the negative impact of iron overload on morbidity/mortalityEuropean Journal of Haematology, 2007
- Role of Liver Biopsy in the Diagnosis of Hepatic Iron Overload in the Era of Genetic TestingAmerican Journal of Clinical Pathology, 2002
- The ferritins: molecular properties, iron storage function and cellular regulationBiochimica et Biophysica Acta (BBA) - Bioenergetics, 1996
- Human serum ferritin G-peptide is recognized by anti-L ferritin subunit antibodies and concanavalin-ABritish Journal of Haematology, 1987