Clinical significance of RBC ferritin level in refractory anemias and chronic myeloid leukemia

Aim. To find out if the RBC ferritin elevation can serve as an additional criterion of inefficient erythropoiesis during progression of chronic myeloid leukemia (CML) and in various types of refractory anemia. Material and methods. The study group consisted of 56 MDS patients and 73 patients at various stages of CML. 20 healthy donors and 105 patients with verified inefficient erythropoiesis (20 - with B12 deficiency before and after the treatment, 85 - with beta-thalassemia) were the controls. A ferritin level was measured by radioimmunoassay in RBC hemolysates. Results. The RBC ferritin level in all types of refractory anemia was elevated throughout the disease course, increasing with the development of transfusion dependency. The CML progression was also accompanied by RBC ferritin level elevation associated with abnormal erythroid cell accumulation and elevation of intracellular PAS-positive substance (p < 0,05). Conclusion. RBC ferritin level elevation can be considered as an additional biochemical criterion of unefficient erythropoiesis that may be useful in differentiation of anemias, adequate therapy selection and follow-up of erythropoiesis..