Association of serum iron and response to immune checkpoint inhibitors (ICIs) in metastatic clear cell renal cell carcinoma (mccRCC).

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 723-723
Author(s):  
Nityam Rathi ◽  
David D. Stenehjem ◽  
Neeraj Agarwal ◽  
Andrew W Hahn ◽  
Deepika Sirohi ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Serum Iron ◽  
Clear Cell ◽  
Checkpoint Inhibitors ◽  
Transferrin Saturation ◽  
Iron Level ◽  
Eligibility Criteria ◽  
Cell Renal Cell Carcinoma ◽  
Serum Iron Level ◽  
Iron Profile

723 Background: ICIs have improved survival in mRCC patients (pts), yet response rates (RR) to these treatments are variable. Biomarkers predictive of response to ICIs may improve outcomes for mccRCC pts. Genes that promote tumor-specific iron accumulation such as hepcidin (HAMP) or transferrin (TF) are significantly correlated with decreased overall survival in clear cell RCC (TCGA-KIRC). Iron deficiency in cancer patients is positively correlated with tumor stage and inversely proportional to treatment response (PMID: 23567147). Here, we investigate whether serum iron profile may be associated with response to ICIs in mccRCC pts. Methods: Clinical data was obtained from an mRCC registry at the Huntsman Cancer Institute, University of Utah. Analyses were limited to mccRCC pts who had serum iron studies within 6 months before initiating an ICI and had been assessed for RR. ICIs included nivolumab + ipilimumab, atezolizumab, or nivolumab alone. Responses were defined as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD) by RECIST criteria. Clinical benefit (CB) was defined as CR + PR + SD. Descriptive statistics were used to assess associations between iron stores and response to ICIs and IMDC criteria. Results: 36 pts met all aforementioned eligibility criteria (29 were of IMDC intermediate risk, 7 were of IMDC poor risk). 5 pts received a first-line ICI, and the remaining 31 pts received ICIs as salvage therapy. Pts with CB had a significantly higher median serum iron level compared to those with no CB (59 vs 38.5 ug/dL; p=0.024). Furthermore, pts with normal transferrin saturation (TSAT %) were more likely to derive CB from ICIs (p=0.048). No association was found between serum ferritin (a marker of inflammation and tissue iron) and response to ICIs. Conclusions: In this hypothesis-generating study, increased serum iron, and TSAT levels within the normal range are associated with an increased likelihood of response to ICIs in pts with mccRCC. Once validated, these results may establish serum iron profile as a predictive marker of response to ICIs, in addition to providing the rationale for ruling out iron deficiency before starting ICIs.

scholarly journals ROLE OF SERUM IRON AND ITS ASSOCIATION WITH ANEMIC PREVALANCE AMONG PATIENTS WITH DIFFERENT TYPE OF CANCER

2017 ◽  
Vol 5 (5(SE)) ◽  
pp. 37-41
Author(s):  
Andrew Pradeep M ◽  
Indira G ◽  
Sethu Nagarajan R
Keyword(s):  
Iron Deficiency ◽  
Serum Iron ◽  
Physiological Activity ◽  
Iron Concentration ◽  
Active Role ◽  
Control Individual ◽  
Iron Level ◽  
Serum Iron Level ◽  
Immune Effector ◽  
Patients With Cancer

Cancer is a group of diseases in which cells are aggressive, invasive and sometimes metastatic. Nutritional status an important factor that contributes to immune competence for which trace minerals plays a crucial role in the biochemical and physiological activity of the system. Trace element a category of minerals essential for the biological system and plays an active role in immune effector mechanism.  Normal range of iron essential for body metabolism, iron deficiencies leads to anemia which might complicate the event of tumor genesis. Study involved 50 volunteers (36 females, 14 males) of cancer patients of Mohan Nursing Home Madurai. Serum was collected in the informed consent of the patients. Serum iron level was quantified using Atomic Absorption Spectrophotometer. Study documented percentage deviation of serum iron concentration (85%) with severe anemic prevalence from the control individual (without cancer) and also establish an association of iron deficiency with anemic prevalence. Study documented the existence of Iron deficiency which is the most common cause of anemia worldwide. Iron plays a role in oxygen transfer in cytochromes, protein molecules involved in the production of energy in cells and also exhibit certain properties to facilitate antitumor status. Study concludes that serum iron modulations need to be emphasized to minimize the burdenization of the host with Clinical associated complications of Iron deficiency among patients with cancer.

scholarly journals Serum Iron Level as a Potential Predictor of Coronavirus Disease 2019 Severity and Mortality: A Retrospective Study

2020 ◽  
Vol 7 (7) ◽  
Author(s):  
Kang Zhao ◽  
Jucun Huang ◽  
Dan Dai ◽  
Yuwei Feng ◽  
Liming Liu ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Serum Iron ◽  
Iron Status ◽  
Iron Concentration ◽  
Iron Level ◽  
Serum Iron Level ◽  
Amyloid A ◽  
Significant Difference ◽  
Before And After ◽  
Low Serum

Abstract Background Various types of pulmonary diseases are associated with iron deficiency. However, information on iron status in coronavirus disease 2019 (COVID-19) is scarce. Methods This study included 50 hospitalized patients with confirmed COVID-19. The role of serum iron in predicting severity and mortality of COVID-19 was evaluated. Results The most common symptoms of COVID-19 patients in this study were cough (82%), fever (64%), and chest distress (42%). Of the 50 patients, 45 (90%) patients had abnormally low serum iron levels (<7.8 μmol/L). The severity of COVID-19 was negatively correlated with serum iron levels before and after treatment and was positively correlated with C-reactive protein, serum amyloid A, D-dimer, lactate dehydrogenase, urea nitrogen, and myoglobin levels. Decreased serum iron level could predict the transition of COVID-19 from mild to severe and critical illness. Seven (53.8%) patients with a lower serum iron level after treatment in the critical group had died. There was a significant difference in posttreatment serum iron levels between COVID-19 survivors and nonsurvivors. Conclusions Serum iron deficiency was detected in the patients with COVID-19. The severity and mortality of the disease was closely correlated with serum iron levels. Low serum iron concentration was an independent risk factor for death in COVID-19 patients.

scholarly journals Iron Status in Malnourished Children : A Cross Sectional Study

2014 ◽  
Vol 13 (3) ◽  
pp. 50-53
Author(s):  
Shormin Ara Ferdousi ◽  
Rajat Sanker Roy Biswas ◽  
Nayan Kanti Paul ◽  
Mohammed Rezaul Karim
Keyword(s):  
Serum Iron ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Iron Level ◽  
Serum Iron Level ◽  
Cross Sectional ◽  
Malnourished Children ◽  
Different Types

Objectives: Malnutrition is a common condition among children and iron status varies in different types of malnutrition. So the present study is aimed to find the different iron status among severe malnourished children in our context. Methods: A hospital based cross sectional study was done in the Paediatrics ward Chittagong Medical College Hospital in a period of 6 months from January to July 2013 among the 50 cases of malnourished children of age range between 1 to 5 years and Weight for Height Z score(WHZ) was <-2  SD. Sampling technique was continuous purposive sampling. Venous blood was collected to assay the different iron profile mainly serum iron level, total iron binding capacity(TIBC) and transferrin saturation(TSAT). Data was analyzed after correction by SPSS-19. Results: Among the 50 study children of different age groups 15 patients were 1 to 2 years, 18 patients were 2 to 3 years, 10 patients were 3 to 4 years and 7 patients were at 4-5 years of age groups. Among the patients, 29 (58%) of patients were female and 21(42%) of the patients were male. Most of the children were from the families of low socioeconomic status 38(76%). 2(4%) children were from upper middle class who had step mother. Among the selected patients the dominating clinical features were anemia was found among 45(90%) of patients which was mild(66.6%), moderate(26.6%) and severe(6.6%). Skin changes(32%), eye  changes (10%) and hair changes(48%) were also found. Among the 50 study subjects prelacteal feeding was given among 43(86%) children, breast feeding was given 45(90%), exclusive breast feeding was given to 24(48%) of children and complementary feeding after 6 months was given to 29(58%) patients. Among the 50 patients -2 to -3 SD weight for height was found in 20(40%) patients and <-3 SD was found in 30(60%) patients. Most of the children was found to have Mid Upper Arm Circumference (MUAC) 115-125 mm(50%). Iron status was measured among all patients where serum iron level was found 77.72 ± 11.22 mcgm/dl, TIBC was found 340.07 ± 22.67 mcgm/dl and transferrin saturation was found 22.38 ± 2.9 %. Iron status were measured among the different types of malnutrition where serum iron level and transferrin saturation was high among all patients with malnutrition while TIBC was lower than standard level in all patients. Different biochemical status were measured among the different types of malnutrition where serum total protein, serum albumin, Hb% were lower than standard level in all patients.Conclusion: Change in different iron status is a common findings in malnourished children. Screening of all children for anemia and providing iron and folic acid (IFA) or multiple micronutrients (MMN) supplements to children and Infant and Young Child Feeding (IYCF) should be addressed at all level to overcome the situation.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21024

Subclinical Iron Deficiency in Non-Anemic Individuals: A Retrospective Analysis of Korean Health Examinees

2019 ◽  
Vol 143 (1) ◽  
pp. 26-32
Author(s):  
Eun-Hee Nah ◽  
Han-Ik Cho ◽  
Seon Cho ◽  
Suyoung Kim
Keyword(s):  
Iron Deficiency ◽  
Blood Cell ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Reproductive Age ◽  
Iron Level ◽  
Distribution Width ◽  
Elderly Males ◽  
Males And Females

Objectives: Non-anemic individuals may have undetected subclinical iron deficiency (SID). The aims of this study were to determine the prevalence of SID and identify the associated factors for SID. In addition, the screening performance of red blood cell (RBC) indices for SID in health check-ups was assessed. Methods: This study was conducted with 16,485 non-anemic health examinees (3,567 males and 12,918 females) who underwent tests for iron variables (serum iron, total iron-binding capacity, ferritin, and iron saturation) at 16 health-promotion centers in 13 cities in Korea between January 2017 and June 2018. SID was defined as a decreased ferritin level (<24 µg/L in males and <15 µg/L in females) and either a decreased serum iron level (<44 µg/dL in males and <29 µg/dL in females) or a transferrin saturation of <20%. Results: The prevalence rates of SID were 0.6 and 3.3% in males and females, respectively. In terms of age and sex, SID was most prevalent in males aged ≥70 years (7.8%) and females aged 15–49 years (7.6%). There were significant differences in the hemoglobin (Hb) level, white blood cell count, platelet count, mean corpuscular volume, mean corpuscular Hb (MCH), and RBC distribution width (RDW) between the SID and non-SID groups (p < 0.001). The factors associated with SID in males were older age (odds ratio, OR, 1.069, 95% confidence interval, CI, 1.03–1.109, p = 0.004), lower Hb (OR 0.58, 95% CI 0.345–0.976, p = 0.04), lower MCH (OR 0.433, 95% CI 0.298–0.629, p < 0.001), and higher RDW (OR 1.374, 95% CI 1.001–1.887, p = 0.049), while in females they were lower body mass index (BMI; OR 0.929, 95% CI 0.895–0.963, p < 0.001) and younger age (OR 0.954, 95% CI 0.945–0.963, p < 0.001), as well as lower Hb, lower MCH, and higher RDW. The AUC for the MCH (0.877, 95% CI 0.793–0.960 in males; 0.872, 95% CI 0.853–0.890 in females) indicates that the MCH at cut-offs of 29.2 and 29.3 pg are the best discriminators of SID in males and females, respectively (p < 0.001). Conclusions: Reproductive-age females with a lower BMI and elderly males are high-risk groups for SID. MCH is a reliable RBC index for the screening of SID. For the population with defined risk factors, including females with lower BMI and elderly males, screening for SID is needed to prevent the development of anemia.

scholarly journals The U-shaped association of serum iron level with COVID-19 severity: Is iron a potential therapeutic target?

2021 ◽  
Author(s):  
Kentaro Tojo ◽  
Yoh Sugawara ◽  
Yasufumi Oi ◽  
Fumihiro Ogawa ◽  
Takuma Higurashi ◽  
...  
Keyword(s):  
Disease Severity ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
University Hospital ◽  
Iron Level ◽  
Inadequate Response ◽  
Serum Iron Level ◽  
Median Serum ◽  
Iron Binding Capacity

AbstractObjectiveTo evaluate the association between iron metabolism indicators and disease severity in hospitalized patients with coronavirus disease 2019 (COVID-19).DesignTwo-center observational studySettingA university hospital and a core hospital in Yokohama, JapanPatientsAdults with COVID-19 whose serum iron levels were measured within the first 5 days of hospitalization were included. Patients who refused mechanical ventilation were excluded from the study.Measurements and Main ResultsOne hundred thirty-six patients were included in this study. We analyzed the association between COVID-19 severity and serum iron, total iron binding capacity (TIBC), and transferrin saturation (TSAT) levels. Disease severity was defined as the worst respiratory status during hospitalization. Serum iron levels were significantly lower in patients with mild respiratory failure (RF) (n=55, median serum iron level: 24 [interquartile range: 19–42] mg/dL) than in the non-RF group (n=44, 40 [24–80] mg/dL) and the severe RF group (n=37, 60 [23.5–87] mg/dL); however, there were no significant differences in iron levels between the non-RF and severe RF groups (non-RF vs. mild RF: p=0.019, non-RF vs. severe RF: p>0.999, and mild RF vs. severe RF: p=0.009). That is, there was a U-shaped association between serum iron levels and disease severity. TIBC levels decreased significantly with increasing severity; consequently, TSAT was significantly higher in patients with severe RF than in other patients. Multivariate analysis including only patients with RF adjusted for age and sex demonstrated that higher serum iron or TSAT levels were independently associated with development of severe RF.ConclusionsA U-shaped association between serum iron level and RF severity in hospitalized COVID-19 patients was observed. Higher serum iron levels in COVID-19 patients with RF are associated with the development of severe RF, indicating that inadequate response to lower serum iron might be an exacerbating factor for COVID-19.

scholarly journals Association between iron deficiency anaemia and simple febrile seizure in South Indian rural population

2020 ◽  
Vol 7 (12) ◽  
pp. 2355
Author(s):  
Gayathri Durai ◽  
Syamily Parambath ◽  
Rajendiran Ramachari Ramayi
Keyword(s):  
Risk Factor ◽  
Iron Deficiency ◽  
Febrile Seizure ◽  
Serum Iron ◽  
Iron Deficiency Anaemia ◽  
Febrile Seizures ◽  
Iron Level ◽  
Serum Iron Level ◽  
Deficiency Anaemia ◽  
South Indian

Background: Simple febrile seizure is a common problem worldwide, many studies have investigated the etiology and natural history of febrile seizures and evaluated various management strategies, but very little information is available about iron deficiency as a risk factor. Hence, we aimed to determine the association between iron deficiency anaemia and simple febrile seizures in south Indian rural population. Methods: It is an observational study done in paediatrics department at Sri Venkateshwaraa medical college hospital and research centre. A total 120 (60 cases and 60 control) were included in the study. Children with febrile seizures and controls were included fever without seizures. Informed consent was taken from parents of each child. Children were divided into two groups, cases and controls. Serum ferritin level, Hb, HCT and MCV levels were assessed.Results: Mean Hb level in cases and controls were 9.1±1.2 and 12.7±1.7 mg/dl respectively. Mean MCV value in cases and controls was 78.1±6.2 and 81.4±6.9 respectively. Mean serum iron level in cases was 29.9±4.9 and in controls mean serum iron level was 42.8±7.4. Conclusions: Iron deficiency anaemia is considered as a risk factor for febrile seizures in children.

scholarly journals The U-shaped association of serum iron level with disease severity in adult hospitalized patients with COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kentaro Tojo ◽  
Yoh Sugawara ◽  
Yasufumi Oi ◽  
Fumihiro Ogawa ◽  
Takuma Higurashi ◽  
...  
Keyword(s):  
Disease Severity ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Total Iron ◽  
Iron Level ◽  
Inadequate Response ◽  
Lower Serum ◽  
Serum Iron Level ◽  
Iron Binding Capacity

AbstractCoronavirus disease 2019 (COVID-19) is an emerging infectious disease that leads to severe respiratory failure (RF). It is known that host exposure to viral infection triggers an iron-lowering response to mitigate pathogenic load and tissue damage. However, the association between host iron-lowering response and COVID-19 severity is not clear. This two-center observational study of 136 adult hospitalized COVID-19 patients analyzed the association between disease severity and initial serum iron, total iron-binding capacity (TIBC), and transferrin saturation (TSAT) levels. Serum iron levels were significantly lower in patients with mild RF than in the non-RF group; however, there were no significant differences in iron levels between the non-RF and severe RF groups, depicting a U-shaped association between serum iron levels and disease severity. TIBC levels decreased significantly with increasing severity; consequently, TSAT was significantly higher in patients with severe RF than in other patients. Multivariate analysis including only patients with RF adjusted for age and sex demonstrated that higher serum iron and TSAT levels were independently associated with the development of severe RF, indicating that inadequate response to lower serum iron might be an exacerbating factor for COVID-19.

scholarly journals Determination of Level of Serum Iron among Routine Iron Supplemented Pregnant Women Attending Private Clinic in Sulaimani City, Kurdistan-Iraq

2021 ◽  
Vol 11 (1) ◽  
pp. 76-79
Author(s):  
Sardar M. Weli ◽  
Osama H. Shareef ◽  
Syamand A. Qadir
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Serum Iron ◽  
Age Groups ◽  
First Trimester ◽  
Private Clinic ◽  
Iron Level ◽  
Serum Iron Level ◽  
Significant Difference ◽  
Questionnaire Form

Iron deficiency, with or without anemia, is common in pregnant women and more than half of the anemia’s in the world are due to the deficiency of iron in the serum. The aims of this study were to determine the percentage and level of serum iron among iron supplemented pregnant women in different trimesters and in different age groups among supplemented pregnant women in Sulaimani city. This study was carried out in the private clinic in the Sulaimani city-Kurdistan Region of Iraq. The pregnant women were participated and enrolled between the first of December 2018 and first of December 2019. Two hundred and seventy-five healthy and iron supplemented pregnant women were selected randomly and the questionnaire form, which contains information about age of mothers and their gestational age, was filled and serum iron level was measured by COBAS C111 analyzer. The results of this study found that the percentage of iron deficiency among participants was high 33%, 45%, and 52.6 % in the first trimester in different age groups <25, 25–35, and above 35 years old, respectively. However, in the third trimesters decreased to 12.5%, 7.1%, and 3.7% in <25, 25–35, and above 35 years old, respectively. Regarding serum iron levels, the present study found that there were significant differences between ages 25 and 35 with age <25 years. However, there was no significant difference between first, second, and third trimesters. This study concludes that the percentage of iron deficiency among supplemented pregnant women was high compared to other cities or other countries. Pregnant women who their ages <25 are at risk of serum iron deficiency. On the other hand, pregnancy trimesters had no effects on the serum iron level among supplemented pregnant women.

scholarly journals Seasonal alterations in serum iron levels in elite football players

2008 ◽  
Vol 136 (9-10) ◽  
pp. 524-528
Author(s):  
Sead Malicevic ◽  
Dejan Nesic ◽  
Ilija Rosic
Keyword(s):  
Iron Deficiency ◽  
Iron Metabolism ◽  
Functional Ability ◽  
Serum Iron ◽  
Deficiency Anemia ◽  
Football Players ◽  
Iron Level ◽  
Training Process ◽  
Serum Iron Level ◽  
Oxygen Transport System

INTRODUCTION It is very important to monitor levels of serum iron and other factors of iron metabolism and oxygen transport system as they play a very important role in functional ability of football players. A decrease in serum iron level can be the very first sign of development of iron deficiency anemia, which seriously influences health and functional ability of an athlete and is a common problem in competitive sports. OBJECTIVE The aim of this study was to observe and evaluate changes in serum iron values during the competition season in relation to the training process. METHOD During four years, serum iron level was measured in 28-34 players of one of the top football clubs in Serbia, four times a year: at the beginning and at peak-point of both half seasons. Differences between basic and control findings, relative and absolute changes in serum iron levels and statistical significance of the findings were than calculated. RESULTS There was a significant decrease in mean serum iron levels on each control test, compared to basic values. Mean value of control serum iron levels is significantly lower than mean of preseason values (20.64? 6.58 vs. 16.38?5.51 ?mol/l). CONCLUSION A significant decrease in serum iron level among footballers during both half-seasons is most probably due to an increased loss and/or diminished absorption resulting from a high intensity training process. Because the decline in serum iron may be an early sign of iron store depletion and iron deficiency anemia, it is very important to evaluate it regularly, along with other factors of iron metabolism and oxygen transport system.

scholarly journals LOW SERUM IRON LEVEL AND LYMPHOCYTE DNA DAMAGE AMONG ADULTS

2012 ◽  
Vol 02 (02) ◽  
pp. 30-35
Author(s):  
Pinak Samal ◽  
Suchetha Kumari N. ◽  
Indira R. Samal ◽  
Kathyayani Sathish
Keyword(s):  
Oxidative Stress ◽  
Dna Damage ◽  
Iron Deficiency ◽  
Comet Assay ◽  
Serum Iron ◽  
Iron Level ◽  
Alkaline Comet Assay ◽  
Serum Iron Level ◽  
The World ◽  
Low Serum

AbstractCellular DNA damage has been related to both external and internal factors. Serum Iron is one of the factors which has importance in the oxidative status of the cell. Higher iron levels have been found to be associated with imbalance in the oxidation-antioxidant system and has been associated with DNA damage due to oxidative stress. However, oxidative stress and DNA damage has also been reported in iron deficiency states, in some studies. It appears that the body iron level should be maintained at optimum level for a balanced scenario and both iron excess as well as iron deficiency states may be associated with oxidative stress and attendant DNA damage. In this study, the blood collected from eighty four volunteers (fifty six males and twenty eight females) was subjected to estimation of serum iron (Bathophenanthroline method). Also, Lymphocyte DNA damage was ascertained by Alkaline Comet Assay method (Qualitative assessment only). The range of serum iron in this group was found to be between 39.91 μgm/dl – 93.55 μgm/dl in females and between 37.7 μgm/dl – 133.63 μgm/dl in males. Very high as well as very low serum iron was not found in this study group as the volunteers were all ambulatory and asymptomatic. Among the volunteers who had serum iron less than 50 μgm/dl(N=17), eleven (64.7%) had evidence of DNA damage as per the alkaline comet assay. Among the group having serum iron 51-70 μgm/dl (N=34), fourteen (41%), had evidence of DNA damage. Similarly, among the group, having serum iron 71-90 μgm/dl (N=27), evidence of DNA damage was seen in ten (37%) persons. There were very few persons with serum iron more than 91 μgm/dl (N= 6) and out of them two had evidence of DNA damage. In total, out of 84 persons, thirty seven (44%) had evidence of DNA damage as per alkaline comet assay. This trend of inverse dose response relationship was also noticed separately among males as well as in females. This is a preliminary exploratory study in India (although a few similar reports also exist in studies done in other parts of the world) and admittedly, had not taken into account of other confounding factors. Nevertheless, the findings suggesting association of low serum iron level and DNA damage, which has also been reported in some earlier studies at other parts of the world, need further examination through larger controlled studies.

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