West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter. Asian Pacific Journal of Cancer Prevention 1513-7368 25 8 2024 08 01 Impact of Serum Ferritin and Iron Overload on Acute Myeloid Leukemia Outcomes: A Systematic Review and Meta-Analysis 2951 2962 91295 10.31557/APJCP.2024.25.8.2951 EN Sanambar Sadighi Hematology-Oncology Department, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran. Efe Sahinoglu University of Toronto, Toronto, Canada. 0009-0005-4580-3311 Ahmed Haider Kubba University of Toronto, Toronto, Canada. Jhanvi Patel University of Toronto, Toronto, Canada. Sayyideh Forough Hosseini University of Toronto, Toronto, Canada. Mohammad Ali Shafiee University of Toronto, Toronto, Canada. 0000-0002-4444-4223 Bakhtavar Qureshi Residency of Family Medicine, Toronto, Canada. Journal Article 2024 04 06 Objective: To evaluate the iron overload among individuals with acute myeloid leukemia (AML) who have not received red blood cell transfusions. Methods: A comprehensive search was conducted in Embase, PubMed, PubMed Central, Web of Science, NIH, and Blood Library databases up to September 2023. The search strategy included keywords related to AML, iron overload, serum ferritin, survival, outcomes, and inflammation. Manual searches through included articles and relevant references were also performed. From 1650 initial articles, 16 studies involving 8752 patients met the inclusion criteria for systematic review. Statistical analysis used hazard ratios (HR) and confidence intervals (CI).  Results: The systematic review and meta-analysis revealed a statistically significant association between high serum ferritin (SF) levels and poor outcomes in AML patients before starting chemotherapy. Elevated SF levels (>1000 mg/L) were associated with lower overall survival (OS) and event-free survival (EFS) (HR for OS: 1.99, 95% CI: 1.48-2.66; HR for EFS: 2.29, 95% CI: 1.73-3.05). Elevated SF levels were inversely correlated with the gradual onset of infections, indicating an increased risk of early mortality (p<0.05). Conclusion: Elevated serum ferritin levels are significantly associated with poor outcomes in AML patients before treatment initiation. These findings highlight the importance of monitoring iron levels in these patients to improve prognostic assessments and treatment strategies. https://journal.waocp.org/article_91295_e5759c131d17402577cd4baabefdcf54.pdf