Effect of Serum Ferritin Level on the Response to Standard Chemotherapy in Acute Myeloid Leukemia Patients

Abstract

Background: A high ferritin level in acute myeloid leukemia (AML) patients acts as a growth factor for leukemic cells, and its antioxidant effect may reduce the effectiveness of cytotoxic chemotherapy drugs, including anthracyclines. Methods: All adult patients with AML from 2013 to 2023, who had received 7+3 chemotherapy protocol at Namazi and Amir hospitals in Shiraz provided that Ferritin and C-reactive protein (CRP) level were checked before chemotherapy were included. We evaluated complete remission rate, overall survival (OS) and event-free survival (EFS) in 67 new cases. Results: The EFS was significantly longer in patients with serum ferritin levels below 1000 ng/mL compared to those with serum ferritin levels of 1000 ng/mL or higher [estimated mean and 95% CI: 25.65 (19.29 - 32) vs 11.6 (8.19 - 15.13) months, P = 0.018]. Conclusions: Ferritin levels at diagnosis are indicative of patient survival. The AML patients with serum ferritin levels greater than 1000 experienced shorter EFS compared to those with ferritin levels below 1000.