Hepatic and cardiac and iron overload detected by T2* magnetic resonance (MRI) in patients with myelodisplastic syndrome: A cross-sectional study

L. F. Mantovani, F. P.S. Santos, G. F. Perini, C. M.B. Nascimento, L. P. Silva, C. K. Wroclawski, B. P. Esposito, M. S.S. Ribeiro, E. D.R.P. Velloso, C. H. Nomura, Fernando Uliana Kay, R. H. Baroni, N. Hamerschlak, S. Schuster

Research output: Contribution to journalArticle

Abstract

Introduction: Transfusion-dependent anemia and iron overload are associatedwith reduced survival in myelodysplastic syndrome (MDS). This cross-sectional study aimed to evaluate the prevalence of hepatic and cardiac overload in patients with MDS as measured by T2* magnetic resonance imaging (MRI), and its correlation with survival. Methods: MDS or chronic myelomonocytic leukemia patients had iron overload evaluated by T2* MRI. HIO was considered when hepatic iron concentration ≥ 2 g/mg. Cardiac iron overload was considered with a T2*-value < 20 ms. Results: Among 71 patients analyzed, median hepatic iron concentration was 3.9 g/mg (range 0.9–16 g/mg), and 68%of patients had hepatic iron overload. Patients with hepatic iron overload had higher mean ferritin levels (1182 ng/mL versus 185 ng/mL, p < 0.0001), transferrin saturation (76% versus 34%, p < 0.0001) and lower survival rates. Median cardiac T2*value was 42 ms (range 19.7–70.1 ms), and only one patienthad a T2* value indicative of cardiac iron overload. Conclusions: Hepatic iron overload is found in two thirds of patients, even in cases without laboratory signs of iron overload. Hepatic iron overload by T2* MRI is associated with a decreased risk of survival in patients with MDS.

LanguageEnglish (US)
Pages53-57
Number of pages5
JournalLeukemia Research
Volume76
DOIs
StatePublished - Jan 1 2019

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Iron Overload
Magnetic Resonance Spectroscopy
Cross-Sectional Studies
Magnetic Resonance Imaging
Liver
Myelodysplastic Syndromes
Survival
Iron
Leukemia, Myelomonocytic, Chronic
Transferrin
Ferritins
Anemia
Survival Rate

Keywords

  • Iron overload
  • Magnetic resonance
  • Myelodysplastic-myeloproliferative diseases

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Mantovani, L. F., Santos, F. P. S., Perini, G. F., Nascimento, C. M. B., Silva, L. P., Wroclawski, C. K., ... Schuster, S. (2019). Hepatic and cardiac and iron overload detected by T2* magnetic resonance (MRI) in patients with myelodisplastic syndrome: A cross-sectional study. Leukemia Research, 76, 53-57. https://doi.org/10.1016/j.leukres.2018.12.001

Hepatic and cardiac and iron overload detected by T2* magnetic resonance (MRI) in patients with myelodisplastic syndrome : A cross-sectional study. / Mantovani, L. F.; Santos, F. P.S.; Perini, G. F.; Nascimento, C. M.B.; Silva, L. P.; Wroclawski, C. K.; Esposito, B. P.; Ribeiro, M. S.S.; Velloso, E. D.R.P.; Nomura, C. H.; Kay, Fernando Uliana; Baroni, R. H.; Hamerschlak, N.; Schuster, S.

In: Leukemia Research, Vol. 76, 01.01.2019, p. 53-57.

Research output: Contribution to journalArticle

Mantovani, LF, Santos, FPS, Perini, GF, Nascimento, CMB, Silva, LP, Wroclawski, CK, Esposito, BP, Ribeiro, MSS, Velloso, EDRP, Nomura, CH, Kay, FU, Baroni, RH, Hamerschlak, N & Schuster, S 2019, 'Hepatic and cardiac and iron overload detected by T2* magnetic resonance (MRI) in patients with myelodisplastic syndrome: A cross-sectional study' Leukemia Research, vol. 76, pp. 53-57. https://doi.org/10.1016/j.leukres.2018.12.001
Mantovani, L. F. ; Santos, F. P.S. ; Perini, G. F. ; Nascimento, C. M.B. ; Silva, L. P. ; Wroclawski, C. K. ; Esposito, B. P. ; Ribeiro, M. S.S. ; Velloso, E. D.R.P. ; Nomura, C. H. ; Kay, Fernando Uliana ; Baroni, R. H. ; Hamerschlak, N. ; Schuster, S. / Hepatic and cardiac and iron overload detected by T2* magnetic resonance (MRI) in patients with myelodisplastic syndrome : A cross-sectional study. In: Leukemia Research. 2019 ; Vol. 76. pp. 53-57.
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abstract = "Introduction: Transfusion-dependent anemia and iron overload are associatedwith reduced survival in myelodysplastic syndrome (MDS). This cross-sectional study aimed to evaluate the prevalence of hepatic and cardiac overload in patients with MDS as measured by T2* magnetic resonance imaging (MRI), and its correlation with survival. Methods: MDS or chronic myelomonocytic leukemia patients had iron overload evaluated by T2* MRI. HIO was considered when hepatic iron concentration ≥ 2 g/mg. Cardiac iron overload was considered with a T2*-value < 20 ms. Results: Among 71 patients analyzed, median hepatic iron concentration was 3.9 g/mg (range 0.9–16 g/mg), and 68{\%}of patients had hepatic iron overload. Patients with hepatic iron overload had higher mean ferritin levels (1182 ng/mL versus 185 ng/mL, p < 0.0001), transferrin saturation (76{\%} versus 34{\%}, p < 0.0001) and lower survival rates. Median cardiac T2*value was 42 ms (range 19.7–70.1 ms), and only one patienthad a T2* value indicative of cardiac iron overload. Conclusions: Hepatic iron overload is found in two thirds of patients, even in cases without laboratory signs of iron overload. Hepatic iron overload by T2* MRI is associated with a decreased risk of survival in patients with MDS.",
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AU - Mantovani, L. F.

AU - Santos, F. P.S.

AU - Perini, G. F.

AU - Nascimento, C. M.B.

AU - Silva, L. P.

AU - Wroclawski, C. K.

AU - Esposito, B. P.

AU - Ribeiro, M. S.S.

AU - Velloso, E. D.R.P.

AU - Nomura, C. H.

AU - Kay, Fernando Uliana

AU - Baroni, R. H.

AU - Hamerschlak, N.

AU - Schuster, S.

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N2 - Introduction: Transfusion-dependent anemia and iron overload are associatedwith reduced survival in myelodysplastic syndrome (MDS). This cross-sectional study aimed to evaluate the prevalence of hepatic and cardiac overload in patients with MDS as measured by T2* magnetic resonance imaging (MRI), and its correlation with survival. Methods: MDS or chronic myelomonocytic leukemia patients had iron overload evaluated by T2* MRI. HIO was considered when hepatic iron concentration ≥ 2 g/mg. Cardiac iron overload was considered with a T2*-value < 20 ms. Results: Among 71 patients analyzed, median hepatic iron concentration was 3.9 g/mg (range 0.9–16 g/mg), and 68%of patients had hepatic iron overload. Patients with hepatic iron overload had higher mean ferritin levels (1182 ng/mL versus 185 ng/mL, p < 0.0001), transferrin saturation (76% versus 34%, p < 0.0001) and lower survival rates. Median cardiac T2*value was 42 ms (range 19.7–70.1 ms), and only one patienthad a T2* value indicative of cardiac iron overload. Conclusions: Hepatic iron overload is found in two thirds of patients, even in cases without laboratory signs of iron overload. Hepatic iron overload by T2* MRI is associated with a decreased risk of survival in patients with MDS.

AB - Introduction: Transfusion-dependent anemia and iron overload are associatedwith reduced survival in myelodysplastic syndrome (MDS). This cross-sectional study aimed to evaluate the prevalence of hepatic and cardiac overload in patients with MDS as measured by T2* magnetic resonance imaging (MRI), and its correlation with survival. Methods: MDS or chronic myelomonocytic leukemia patients had iron overload evaluated by T2* MRI. HIO was considered when hepatic iron concentration ≥ 2 g/mg. Cardiac iron overload was considered with a T2*-value < 20 ms. Results: Among 71 patients analyzed, median hepatic iron concentration was 3.9 g/mg (range 0.9–16 g/mg), and 68%of patients had hepatic iron overload. Patients with hepatic iron overload had higher mean ferritin levels (1182 ng/mL versus 185 ng/mL, p < 0.0001), transferrin saturation (76% versus 34%, p < 0.0001) and lower survival rates. Median cardiac T2*value was 42 ms (range 19.7–70.1 ms), and only one patienthad a T2* value indicative of cardiac iron overload. Conclusions: Hepatic iron overload is found in two thirds of patients, even in cases without laboratory signs of iron overload. Hepatic iron overload by T2* MRI is associated with a decreased risk of survival in patients with MDS.

KW - Iron overload

KW - Magnetic resonance

KW - Myelodysplastic-myeloproliferative diseases

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