Hubungan Feritin dan Blast pada Fase Awal Induksi dan Fase Remisi di Pasien Anak dengan Acute Lymphoblastic Leukemia

Abstract

Objective : Acute lymphoblastic leukemia (ALL) condition may interfere iron synthesis. Iron also plays an important role in the progression of leukemia because the growth of leukemia cells is iron-dependent cells. Excess iron is linked to a poor prognosis and significantly become 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. Blast cells are a hallmark in diagnosing an acute leukemia. The aim of this study is to evaluate the correlation serum ferritin level and blast level in pediatric patients with ALL in the diagnosis and remission phases. Methods : An analytical observational prospective cohort study was conducted to pediatric patients with ALL in pediatric ward Haji Adam Malik hospital Medan from August – February 2023. Physical examination and blood sampling for complete blood count and serum ferritin level assessment and blast level were carried out. Bivariate analysis using Wilcoxon test was used to compare serum ferritin level also blast level during early diagnosis and remission phases in ALL pediatric patients. Correlation between ferritin level and blast during early diagnosis and remission phases was analyzed using Spearman test. Results : Ferritin levels were higher in the newly diagnosed patient group with a median value of 1751 μg/L (409-9250 μg/L) than the group at remission phase with a median value of 400 μg/L (102-1.202 μg/L). There were significant relationships between ferritin levels and blast level in the newly diagnosed group (p<0.05, r=0.3) , but not in the remission phases (p>0.05). Conclusion: Serum ferritin level were higher in the newly diagnosed patient group that the group at remission phase. There were significant relationships between ferritin levels and blast level in the newly diagnosed group, but not in the remission phases.