Non-protein bound iron (NPBI) is able to catalyse oxidative reactions, causing damage to vital structures. Adverse effects induced by cisplatin seem, in part, to be mediated by free radicals. In the present study, we have measured plasma NPBI, various other iron parameters and antioxidants in 28 cancer patients undergoing cisplatin-based chemotherapy at various time points before and during chemotherapy. No NPBI was present prior to therapy, but within 1–4 days following the first administration of chemotherapy, mean NPBI rose significantly to 10.6±6.6 µmol/l (range, 0.6–21.3 µmol/l) in 18 (64.3%) of the 28 patients measured. The rise in NPBI was accompanied by a significant rise in total plasma iron and ferritin and a marked decrease in the latent iron-binding capacity. Concomitantly, plasma vitamins C and E decreased significantly, indicating consumption of antioxidants. Similar observations were also made during the fourth chemotherapy cycle. The increase in NPBI preceded and correlated significantly with chemotherapy toxicity, such as a decrease in leucocyte count and haemoglobin, with a transient rise in various liver enzymes and with known cisplatin-related toxicity, i.e. the loss of renal and hearing function. In conclusion, cisplatin chemotherapy induces oxidative damage which rapidly leads to release of iron from intracellular proteins and the appearance of NPBI. Bone marrow, red blood cells, liver and kidney seem to be a likely source of NPBI. The observed high levels of NPBI may be a major causative determinant in chemotherapy-induced toxicity.
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May 2004
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Research Article|
May 01 2004
Non-protein bound iron release during chemotherapy in cancer patients
N. I. WEIJL;
N. I. WEIJL
*Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
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T. J. ELSENDOORN;
T. J. ELSENDOORN
*Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
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R. M. W. MOISON;
R. M. W. MOISON
†Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
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E. G. W. M. LENTJES;
E. G. W. M. LENTJES
‡Department of Clinical Chemistry, Leiden University Medical Center, Leiden, The Netherlands
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R. BRAND;
R. BRAND
§Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
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H. M. BERGER;
H. M. BERGER
†Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
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S. OSANTO
*Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
Correspondence: Dr S. Osanto (e-mail [email protected]).
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Publisher: Portland Press Ltd
Received:
August 13 2003
Revision Received:
December 10 2003
Accepted:
December 11 2003
Accepted Manuscript online:
December 11 2003
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2004 The Biochemical Society
2004
Clin Sci (Lond) (2004) 106 (5): 475–484.
Article history
Received:
August 13 2003
Revision Received:
December 10 2003
Accepted:
December 11 2003
Accepted Manuscript online:
December 11 2003
Citation
N. I. WEIJL, T. J. ELSENDOORN, R. M. W. MOISON, E. G. W. M. LENTJES, R. BRAND, H. M. BERGER, S. OSANTO; Non-protein bound iron release during chemotherapy in cancer patients. Clin Sci (Lond) 1 May 2004; 106 (5): 475–484. doi: https://doi.org/10.1042/CS20030271
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