Iron deficiency in children at the time of initial neuroblastoma diagnosis

Importance:There is a high incidence of iron deficiency in children worldwide.Notably,however,while iron deficiency is the most common cause of anemia,little is known about the prevalence and different types of iron deficiency in neuroblastoma patients.Objective:The aim of the present study was to investigate the prevalence of iron deficiency in patients newly diagnosed with neuroblastoma.Methods:A total of 195 newly diagnosed neuroblastoma patients from November 2015 to January 2018 were analyzed retrospectively.The survival analysis was estimated by the Kaplan-Meier method.Results:Of the 195 neuroblastoma patients included in the study,121(62.1%)had iron deficiency,55(28.2%)had absolute iron deficiency,and 66(33.9%)had functional iron deficiency.Being aged≥18 months,tumor originating in the abdomen,International Neuroblastoma Risk Group Staging System M,high-risk neuroblastoma,lactate dehydrogenase≥1500 U/L,neuron-specific enolase≥100 U/L,unfavorable histologic category,MYCN amplification,chromosome 1p loss,and bone marrow metastasis were associated with significantly higher rates of functional iron deficiency(P<0.05).Interpretation:Functional iron deficiency at the time of initial neuroblastoma diagnosis predicted lower event-free survival.Long-term effects of iron supplementation in neuroblastoma patients with different types of iron deficiency need to be further studied.