{
  "abstract": "Background: Serum ferritin while used widely, is often unable reflect organ-specific iron burden in thalassemia. We evaluated the adequacy of ferritin-guided chelation in predicting iron overload and examined determinants of ferritin–MRI discordance. Methods: 65 children and young adults with thalassemia undergoing MRI T2∗ assessment were included. Serial ferritin measurements over prior 6–12 months were used to derive mean ferritin and variability. Primary outcomes were myocardial iron overload (cardiac T2∗ <20 ms) and moderate-to-severe hepatic iron overload. Predictors spanning iron exposure, disease biology, and ferritin dynamics were analysed using Firth penalized logistic regression, with model performance assessed by bootstrap-corrected AUC. Results: Hepatic iron overload was present in 77% and myocardial iron overload in 22% of patients despite ferritin-guided chelation. Ferritin showed moderate correlation with cardiac T2∗ (r = −0.51) and weaker correlation with hepatic T2∗ (r = −0.40), with substantial inter-individual variability. In multivariable analysis, age, transfusion-dependent status, and ferritin variability were independently associated with myocardial iron overload, whereas mean ferritin was not. Model discrimination was good (AUC 0.83). Ferritin–MRI discordance was observed in 38% of patients. Conclusion: Ferritin-guided chelation does not reliably predict organ-specific iron burden. Incorporating MRI is helpful for accurate detection of clinically significant iron overload.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pediatric Hematology Oncology, Post Graduate Institute of Child Health (PGICH), Noida, Uttar Pradesh, India",
    "Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India",
    "Department of Pediatric Hematology Oncology, Post Graduate Institute of Child Health (PGICH), Noida, Uttar Pradesh, India; Corresponding author. Department of Paediatric Hematology Oncology, Post Graduate Institute of Child Health, Noida, India.",
    "Department of Hematology, All India Institute of Medical Sciences, New Delhi, India"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Shruti Verma"
    },
    {
      "affs": [
        1
      ],
      "name": "Aprateem Mukherjee"
    },
    {
      "affs": [
        2
      ],
      "name": "Nita Radhakrishnan"
    },
    {
      "affs": [
        1
      ],
      "name": "Vineeta Ojha"
    },
    {
      "affs": [
        0
      ],
      "name": "Aditi Tulsiyan"
    },
    {
      "affs": [
        0
      ],
      "name": "Sudipto Bhattacharya"
    },
    {
      "affs": [
        0
      ],
      "name": "Anuj Singh"
    },
    {
      "affs": [
        0
      ],
      "name": "Usha Bindal"
    },
    {
      "affs": [
        3
      ],
      "name": "Tulika Seth"
    },
    {
      "affs": [
        1
      ],
      "name": "Priya Jagia"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6at0scxmr0cvz.bib",
  "cited_by": 0,
  "doi": "10.1016/j.phoj.2026.101178",
  "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S2468124526003761",
  "id": "6at0scxmr0cvz",
  "issns": [
    "2468-1245"
  ],
  "landing_url": "https://doi.org/10.1016/j.phoj.2026.101178",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RJ1-570"
    ],
    [
      "openalex",
      "2716|Hemoglobinopathies and Related Disorders"
    ]
  ],
  "openalex": "W7221673656",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-30",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/6at0scxmr0cvz.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:44:51Z",
      "native_id": "1854062d4b9f4f198c50b2ce3e67567d",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.phoj.2026.101178"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2716|Hemoglobinopathies and Related Disorders",
      "subfield": "human-genetics"
    }
  ],
  "title": "MRI-detected hepatic and cardiac iron overload despite ferritin-guided chelation in thalassemia: A predictive modelling study",
  "title_text": "MRI-detected hepatic and cardiac iron overload despite ferritin-guided chelation in thalassemia: A predictive modelling study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:44:51Z",
  "url": "https://research.draconitic.com/paper/6at0scxmr0cvz",
  "venue": "Pediatric Hematology Oncology Journal",
  "versions": []
}