Evidence map›Paper›PMID 38961599›Full record

ArticlePediatric blood & cancer2024

Diagnostic pitfalls in assessment of ferritin following CAR-T-cell therapy: Understanding the hook effect.

Roa Harb, Tatiana C Coverdell, Haneen Shalabi, Nirali N Shah

Abstract readCase Reports
In one paragraph

Article in Pediatric blood & cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Hook effect for ferritin immunoassays: implications for clinical practice.Clinical chemistry and laboratory medicine · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Roa HarbDepartment of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.ORCID 0009-0006-0219-1164
Tatiana C CoverdellDepartment of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
Haneen ShalabiPediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Nirali N ShahPediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.ORCID 0000-0002-8474-9080

Funding

Immunotherapeutic approaches to treat pediatric hematologic malignanciesZIABC011823 · NCI · DIVISION OF BASIC SCIENCES - NCI · PI SHAH, NIRALI · 2019 to 2025
$6.1M
Comprehensive Interrogation of Toxicity Profiles Associated with Novel CAR T-cell ConstructsZIABC012187 · NCI · DIVISION OF BASIC SCIENCES - NCI · PI SHAH, NIRALI · 2024 to 2025
$1.6M
Center of Cancer ResearchCLC NIH HHS Z99 CL999999Intramural NIH HHS Z99 CL999999Intramural NIH HHS ZIA BC011823Intramural Research ProgramNCI NIH HHS ZIA BC 011823NIH HHS
6 · The paper itself

Abstract

The hook effect is a well-described but clinically underappreciated immunoassay interference, where a falsely lowered result is caused by analyte excess. We describe a situation in which ferritin immunoassay results from a 27-year-old female with immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome were more than 1000 times lower at a reference laboratory than those determined in-house after dilution. This case underscores the importance for clinical care providers to be aware of the impact of the hook effect on ferritin measurements, and to promptly communicate with the laboratory when there are discrepancies between clinical symptoms and test results.

Indexed as

FerritinsImmunotherapy, AdoptiveLymphohistiocytosis, HemophagocyticAdultFemaleHumansImmunoassayReceptors, Chimeric AntigenFerritinsReceptors, Chimeric Antigencytokine release syndromeferritinhook effectimmune effector cell‐associated hemophagocytic lymphohistiocytosis‐like syndromeimmunoassay interference

Identifiers

PMID38961599
PMCPMC11268996

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.