Early clinical impact of iron overload in stem cell transplantation. A prospective study.
Toxic-infectious complications may be related with iron toxicity after a stem cell transplant (SCT). Eighty one patients who underwent SCT were prospectively evaluated over 3 months for mucositis, bacteraemia and febrile days. Pre-SCT transferrin saturation (TS), ferritin level and the number of days with TS >or= 80% after transplant were determined. A ferritin level >1,500 microg/l predicted the appearance of severe mucositis, bacteraemia and days with fever in univariate (P = 0.03, P = 0.03 and P = 0.03) and multivariate analysis (P = 0.03, P = 0.006 and P = 0.002). Nevertheless, further statistical studies revealed that the predictive value of pre-SCT ferritin levels was restricted to AUTO-transplanted patients in both univariate (P = 0.05, P = 0.05 and P < 0.001) and multivariate (P = 0.03, P = 0.05 and P < 0.001) analysis, in contrast with the ALLO-transplanted group where this variable did not reach statistical significance. In conclusion, iron burden seems to influence the appearance of toxic-infectious complications during the first 3 months after transplant in AUTO-transplanted patients.
Altes
Albert
A
Department of Haematology, Hospital de Sant Pau, Autonomous University of Barcelona, Barcelona, Spain. aaltes@hes.scs.es
Remacha
Angel Francisco
AF
Sarda
Pilar
P
Baiget
Montserrat
M
Sureda
Anna
A
Martino
Rodrigo
R
Briones
Javier
J
Brunet
Salut
S
Canals
Carme
C
Sierra
Jorge
J
D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000209:etiology; D005260:Female; D005293:Ferritins / Q000097:blood*; D005334:Fever / Q000209:etiology; D006801:Humans; D007239:Infections / Q000209:etiology; D019190:Iron Overload / Q000150:complications*; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D011446:Prospective Studies; D014168:Transferrin / Q000737:chemistry; D019172:Transplantation Conditioning / Q000009:adverse effects*
D014168:Transferrin; D005293:Ferritins