Serum ferritin level in pediatric patients with acute lymphoblastic leukemia (ALL) in the early stage of diagnosis and remission phase

Abstract

Background: Cancer cells increase iron absorption, interfere with iron storage, and reduce iron excretion. Acute lymphoblastic leukemia (ALL) condition may interfere with the iron synthesis, and the patients usually receive a blood transfusion which leads to iron buildup. Excess iron is linked to a poor prognosis and significantly becomes morbidity and mortality factors. Serum ferritin levels that can be assessed from complete blood count may become a low-cost and sensitive biomarker and prognostic marker for ALL. The aim of this research is to assess serum ferritin levels in pediatric patients with ALL in the diagnosis and remission phases. Methods: An analytical observational cross-sectional study was conducted on pediatric patients with ALL in the pediatric ward Haji Adam Malik hospital Medan from July – October 2021. Physical examination and blood sampling for complete blood count and serum ferritin level assessment were carried out. Bivariate analysis using the Chi-square test was used to compare serum ferritin levels during early diagnosis and remission phases in ALL pediatric patients. Results: Ferritin levels were higher in the newly diagnosed patient group with a median value of 951 µg/L (28.07-6632 µg/L) than the group in remission phase with a median value of 374.5 µg/L (29-2426 µg/L). There were no significant relationships between ferritin levels and BMI, SGOT, and SGPT in the newly diagnosed group. In contrast, the ferritin levels of the patients in the remission group were significantly correlated with SGOT and SGPT.