Iron overload might increase transplant-related mortality in haematopoietic stem cell transplantation

被引:94
作者
Altès, A [1 ]
Remacha, AF [1 ]
Sureda, A [1 ]
Martino, R [1 ]
Briones, J [1 ]
Canals, C [1 ]
Brunet, S [1 ]
Sierra, J [1 ]
Gimferrer, E [1 ]
机构
[1] Autonomous Univ Barcelona, Hosp St Pau, Dept Haematol, Barcelona, Spain
关键词
iron; transferrin saturation; ferritin; survival; TRM; HSCT;
D O I
10.1038/sj.bmt.1703570
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Iron overload (IO) is associated with free radical generation and tissue damage. Our main objective was to ascertain if very high levels (VHL) of ferritin (greater than or equal to3000 mug/l) and transferrin saturation (TS) greater than or equal to100% during conditioning had an impact on overall survival (OS) and transplant-related mortality (TRM) after a haematopoietic stem cell transplantation (HSCT). Levels of ferritin and TS were measured at days -7 and -4, respectively, in 25 patients who underwent HSCT after CY/TBI. The group consisted of 20 men and five women with a median age of 40 years. Fifteen patients were autotransplanted and 10 allotransplanted. Nine of them had a diagnosis of AL, six of CML and 10 of lymphoma. Thirteen of them were in early and 12 in advanced status of disease. VHL of ferritin and TS greater than or equal to100% were associated with a decreased OS (P = 0.001 and P = 0.006, respectively) and an increased TRM (P = 0.003 and P = 0.004, respectively) in univariate survival analysis. Both variables remained significant at multivariate analysis for OS (P = 0.03 and 0.02, respectively) and TS was an independent factor for TRM (P = 0.01). Ferritin was very close to achieving statistical significance for TRM (P = 0.06) in multivariate analysis. In conclusion, VHL of ferritin and TS greater than or equal to100% at conditioning are associated with an increase in toxic deaths after transplant.
引用
收藏
页码:987 / 989
页数:3
相关论文
共 14 条
[1]   Non-transferrin-bound iron induced by myeloablative chemotherapy [J].
Bradley, SJ ;
Gosriwitana, I ;
Srichairatanakool, S ;
Hider, RC ;
Porter, JB .
BRITISH JOURNAL OF HAEMATOLOGY, 1997, 99 (02) :337-343
[2]   Iron overload in cirrhosis -: HFE genotypes and outcome after liver transplantation [J].
Brandhagen, DJ ;
Alvarez, W ;
Therneau, TM ;
Kruckeberg, KE ;
Thibodeau, SN ;
Ludwig, J ;
Porayko, MK .
HEPATOLOGY, 2000, 31 (02) :456-460
[3]  
BULLEN JJ, 1981, REV INFECT DIS, V3, P1127
[4]   PRESENCE OF IRON CATALYTIC FOR FREE-RADICAL REACTIONS IN PATIENTS UNDERGOING CHEMOTHERAPY - IMPLICATIONS FOR THERAPEUTIC MANAGEMENT [J].
CARMINE, TC ;
EVANS, P ;
BRUCHELT, G ;
EVANS, R ;
HANDGRETINGER, R ;
NIETHAMMER, D ;
HALLIWELL, B .
CANCER LETTERS, 1995, 94 (02) :219-226
[5]   Iron depletion by phlebotomy with recombinant erythropoietin prior to allogeneic transplantation to prevent liver toxicity [J].
de la Serna, J ;
Bornstein, R ;
García-Bueno, MJ ;
Lahuerta-Palacios, JJ .
BONE MARROW TRANSPLANTATION, 1999, 23 (01) :95-97
[6]   Safety and efficacy of subcutaneous bolus injection of deferoxamine in adult patients with iron overload [J].
Franchini, M ;
Gandini, G ;
de Gironcoli, M ;
Vassanelli, A ;
Borgna-Pignatti, C ;
Aprili, G .
BLOOD, 2000, 95 (09) :2776-2779
[7]   SEQUENTIAL-CHANGES IN SERUM IRON AND FERRITIN IN PATIENTS UNDERGOING HIGH-DOSE CHEMOTHERAPY AND RADIATION WITH AUTOLOGOUS BONE-MARROW TRANSPLANTATION - POSSIBLE IMPLICATIONS FOR TREATMENT RELATED TOXICITY [J].
GORDON, LI ;
BROWN, SG ;
TALLMAN, MS ;
RADEMAKER, AW ;
WEITZMAN, SA ;
LAZARUS, HM ;
KELLEY, CH ;
MANGAN, C ;
RUBIN, H ;
FOX, RM ;
CREGER, RJ ;
WINTER, JN .
FREE RADICAL BIOLOGY AND MEDICINE, 1995, 18 (03) :383-389
[8]  
HALLIWELL B, 1992, J LAB CLIN MED, V119, P598
[9]   NONSPECIFIC SERUM IRON IN THALASSEMIA - ABNORMAL SERUM IRON FRACTION OF POTENTIAL TOXICITY [J].
HERSHKO, C ;
GRAHAM, G ;
BATES, GW ;
RACHMILEWITZ, EA .
BRITISH JOURNAL OF HAEMATOLOGY, 1978, 40 (02) :255-263
[10]   IRON-METABOLISM AND FUNGAL-INFECTIONS IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES [J].
IGLESIASOSMA, C ;
GONZALEZVILLARON, L ;
SANMIGUEL, JF ;
CABALLERO, MD ;
VAZQUEZ, L ;
DECASTRO, S .
JOURNAL OF CLINICAL PATHOLOGY, 1995, 48 (03) :223-225