title: Iron overload might increase transplant-related mortality in haematopoietic stem cell transplantation.
abstract: 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 (>/=3000 microg/l) and transferrin saturation (TS) >/=100% 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 >/=100% 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 >/=100% at conditioning are associated with an increase in toxic deaths after transplant.
authors.affiliation: Haematology Department, Hospital de Sant Pau, Autonomous University of Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Altès
authors.forename: A F
authors.initials: AF
authors.lastname: Remacha
authors.forename: A
authors.initials: A
authors.lastname: Sureda
authors.forename: R
authors.initials: R
authors.lastname: Martino
authors.forename: J
authors.initials: J
authors.lastname: Briones
authors.forename: C
authors.initials: C
authors.lastname: Canals
authors.forename: S
authors.initials: S
authors.lastname: Brunet
authors.forename: J
authors.initials: J
authors.lastname: Sierra
authors.forename: E
authors.initials: E
authors.lastname: Gimferrer
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000401:mortality; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005293:Ferritins / Q000097:blood; D019337:Hematologic Neoplasms / Q000097:blood / Q000401:mortality / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality*; D006801:Humans; D019190:Iron Overload / Q000097:blood / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014916:Whole-Body Irradiation
chemical_list: D003520:Cyclophosphamide; D005293:Ferritins