Transfusional Iron Overload
Children with thalassemia,
sickle
cell disease, or other anemias that require chronic blood transfusions may accumulate too much iron in their bodies – called iron overload. Because your child’s body has no
natural way to remove the excess iron, the body stores it in internal organs
and body tissues. This can cause damage to the liver, pancreas, heart and endocrine
glands and may affect a child’s growth or development into puberty.
To address iron overload, most children with transfusion-dependent anemia also
receive iron chelation drugs, which help remove the excess iron. The most
effective blood transfusion and iron chelation regimen will differ
significantly from child to child, and it will change over time as the child
grows into adulthood.
Transfusional Iron Overload Evaluations
To ensure your child continues to receive the most effective and
appropriate treatment over time, she should receive an annual evaluation to
detect possible areas of concern related to iron overload. Since every child’s
case is unique, you should discuss with a doctor which tests your
child will need, and if they are needed more or less frequently than once a
year.
A typical transfusional iron overload annual evaluation may include:
- Cardiac testing may
include an echocardiogram, T2* MRI monitoring to assess cardiac iron, 24 Hour Holter
Monitor or event recorder to diagnose arrhythmias and/or ECG
(electrocardiogram)
- Liver and infection testing
may
include annual testing for hepatitis, Liver Function Enzyme Screening, and
liver iron assessment using through biopsy or the non-invasive Ferriscan®
technique.
- Endocrine function testing to assess hormone levels,
bone density and fertility concerns
- Eye and
Ear evaluations for cataracts, tinnitus and other possible
side effects
- Transfusion
monitoring, including a review of transfusion complications and of
pre-transfusion hemoglobin values
- Iron
chelation program monitoring, including a review of chelation options,
dosing, and effectiveness of current program
- Pulmonary function studies
Annual Iron Overload Evaluations at Dana-Farber/Boston Children’s
Dana-Farber/Boston Children's offers Annual Iron Overload Evaluations
to children with transfusion-dependent anemia from around the world. Our
experts specialize in particular blood disorder sub-types, including
thalassemia and sickle cell disease, and have unique expertise in evaluating
transfusion and iron chelation regimens for children. Our Center also can
provide specialized MRI monitoring of body iron by Ferriscan® and T2*
techniques for the liver and heart, which may not be available at many
pediatric centers.
We will work with you and your referring physician to tailor
iron chelation strategies from the drugs currently available and approved, and
we participate in research studies of novel chelation agents to bring better
choices to our patients in the future.
Schedule an Iron Overload Evaluation
To learn more, please call 1-617-355-8246
or fill in our appointment request form. One of our specialized nurse practitioners will discuss with you which annual
evaluation components your child may need, as well as next steps for arranging an evaluation at Dana-Farber/Boston Children’s.