Background: Several studies have shown cardiac diseases as causes of death in myelodisplastic (MDS) patients receiving transfusions. So iron overload may be considered an independent negative prognostic factor. There are few and rather contradictory studies using Magnetic Resonance Imaging (MRI) in the evaluation of MDS syndromes. Aims: We report the baseline MRI findings at the end of the recruitment in the MIOMED (Myocardial Iron Overload in MyElodysplastic Diseases) study. We investigated hepatic, pancreatic and cardiac iron overload and biventricular functional parameters in MDS patients, outlying the differences between transfusion dependent (TD) and non transfusion dependent (non-TD) patients. Methods: MIOMED is an observational, MRI multicentre study in low and intermediate-1 risk MDS patients who have not received regular iron chelation therapy. Forty-eight patients (71.7 }8.5 years, 17 F) underwent the baseline MRI exam. Hepatic T2* values were converted into liver iron concentration (LIC). T2* measurements were performed in pancreatic head, body and tail. Myocardial Summary and Conclusions: As expected, regularly transfused MDS patients showed significantly higher levels of hepatic iron overload, that, however, was present in almost the 30% of non-TD patients, mainly due to increased intestinal iron and augmented erythropoiesis. MIO is not frequent in MDS patients but it can be present also in non-TD patients and in absence of detectable hepatic iron. Conversely, no patients without pancreatic iron overload had cardiac iron overload. Our data remark the importance to check directly for heart iron with a more sensitive segmental approach avoiding to estimate heart iron burden from indirect indicators such as LIC, serum ferritin or transfusion state.
MRI SURVEY IN TRANSFUSION-DEPENDENT AND NON-TRANSFUSION DEPENDENT MDS PATIENTS
CARULLI, GIOVANNI;
2014-01-01
Abstract
Background: Several studies have shown cardiac diseases as causes of death in myelodisplastic (MDS) patients receiving transfusions. So iron overload may be considered an independent negative prognostic factor. There are few and rather contradictory studies using Magnetic Resonance Imaging (MRI) in the evaluation of MDS syndromes. Aims: We report the baseline MRI findings at the end of the recruitment in the MIOMED (Myocardial Iron Overload in MyElodysplastic Diseases) study. We investigated hepatic, pancreatic and cardiac iron overload and biventricular functional parameters in MDS patients, outlying the differences between transfusion dependent (TD) and non transfusion dependent (non-TD) patients. Methods: MIOMED is an observational, MRI multicentre study in low and intermediate-1 risk MDS patients who have not received regular iron chelation therapy. Forty-eight patients (71.7 }8.5 years, 17 F) underwent the baseline MRI exam. Hepatic T2* values were converted into liver iron concentration (LIC). T2* measurements were performed in pancreatic head, body and tail. Myocardial Summary and Conclusions: As expected, regularly transfused MDS patients showed significantly higher levels of hepatic iron overload, that, however, was present in almost the 30% of non-TD patients, mainly due to increased intestinal iron and augmented erythropoiesis. MIO is not frequent in MDS patients but it can be present also in non-TD patients and in absence of detectable hepatic iron. Conversely, no patients without pancreatic iron overload had cardiac iron overload. Our data remark the importance to check directly for heart iron with a more sensitive segmental approach avoiding to estimate heart iron burden from indirect indicators such as LIC, serum ferritin or transfusion state.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
