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Forum Name: Leukemia

Question: ALL and high Ferritin Levels


 mjbs - Thu Sep 18, 2008 12:37 am

My daughter was diagnosed with T-cell Acute Lymphoblastic Leukemia in June 2007. Recently her labs showed her ferritin levels at 1,995. Her iron levels are within the normal range. What does this mean?
 Dr. Safaa Mahmoud - Wed Oct 08, 2008 8:39 am

User avatar Hello,
It would be helpful if you can give us more information about the history of her disease. Information like how she responded to treatment, which disease status she is in right now (especially the results of last bone marrow and blood picture evaluation) , blood transfusion frequency and the condition of other body organs (i.e. liver function tests).

Most of the iron in our body is stored in the form of ferritin, a protein bound iron. Since ferritin is in the inside of cells, its level in the blood is small. Ferritin level may be high or low in association with certain diseases.

Ferritin test is usually performed together with the level of iron and other blood elements to confirm the type of anemia when levels are low. To the contrary, elevated blood levels are seen in cases of increased iron absorption (genetic disorders), following excess blood transfusion, blood hemolysis or damage in certain organs.

Organs that store ferritin (especially the liver, spleen, and bone marrow), when damaged cause elevation in ferritin levels although the total amount of iron in the body is normal. Thus liver diseases, blood diseases including leukemia, infections and inflammatory conditions like arthritis are associated also with high ferritin level mostly with normal level of iron.

Ferritin is also considered an acute-phase reactant that is elevated in the course of an inflammatory disease. In such cases another acute phase reactant: C-reactive protein is studied to examine if this elevated ferritin caused by acute phase reactions (elevated C-reactive protein as well) or not (normal C-reactive protein level).

Very high ferritin levels (greater than 1,000 ng/mL) signify an iron overload and can be seen in conditions like excess iron absorption (congenital hemochromatosis), excess blood transfusions (acquired hemochromatosis) or abnormal erythropoeisis (in bone marrow diseases like MDS).

Too much iron deposition in body organs, like the liver, endocrine organs, pancreas or heart, may negatively affect their function. So this condition needs proper management and follow up.

In your daughter’s case, checking complete blood picture, bone marrow examination if not done recently and if the blood picture result is suggestive, Comb’s test, liver function test, hepatitis markers and blood sugar may be helpful depending on her history.

Please follow up with her doctor and keep us updated.
Best regards.
 mjbs - Wed Oct 08, 2008 9:30 am

Thank you so much for your answer to my question. I appreciate finally getting a complete in-depth answer. I am going o ask my daughter's doctors to run all of the tests you have mentioned. She hasn't had a bone marrow in quite some time and I'm not exactly sure what a complete blood picture is. She has had many transfusions, but none in the last 7 months, would that still possibly be the cause of the high ferritin? Again, thank you so much!
 Dr. Safaa Mahmoud - Wed Oct 08, 2008 3:01 pm

User avatar Hello,
It is our pleasure to help you.
Yes, you better follow up with her doctor and get her checked for all the possible causes even if she did not receive blood transfusion during the past few month.

Proper investigations are essential to treat the underlying cause, getting ferritin level back to normal and to avoid complications.

Thank you for using our website http://www.doctorslounge.com.
Please keep us updated.
Best regards.

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