8 NUCLEAR NAGNETIC RESONANCE AND IRON OVERLOAD IN THALASSEMIA MAIOR AFTER BONE MARROW TRANSPLANTATION

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Abstract

Nuclear magnetic resonance (NHR) imaging is a new and noninvasive technique to detect tissue iron. In fact the signal intensity on spin echo images is as low as tissue iron load is high. We used this technique to assess tissue iron load in 10 β-thalassaeaic maior patients (mean age 11 ± 4.8 years) after bone marrow transplantation (BMT); the follow-up ranged between 10 and 54 months (mean 27.3 months) from transplant. In ail patients a significant correlation has been observed between the summation of signals given out from all the organs examined (liver, spleen and pancreas) with iron overload versus serum ferritin levels (r . 0.64; p < 0.05). Signals obtained from each organ were not correlated with serum ferritin levels, but the only exception was the signal obtained from liver (r = 0.69; p < 0.05).

We conclude that NMR is of great diagnostic validity for the evaluation of iron load of each organ in patients with β-thalassemia subjected to BUT, while serum ferritin levels are related only with total body iron overload. At last these Findings lead us to speculate about the need in these subjects to continue a chelation therapy or to undergo periodic phlebotomy.

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