title: Early clinical impact of iron overload in stem cell transplantation. A prospective study.
abstract: 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.
authors.affiliation: Department of Haematology, Hospital de Sant Pau, Autonomous University of Barcelona, Barcelona, Spain. aaltes@hes.scs.es
authors.forename: Albert
authors.initials: A
authors.lastname: Altes
authors.forename: Angel Francisco
authors.initials: AF
authors.lastname: Remacha
authors.forename: Pilar
authors.initials: P
authors.lastname: Sarda
authors.forename: Montserrat
authors.initials: M
authors.lastname: Baiget
authors.forename: Anna
authors.initials: A
authors.lastname: Sureda
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Martino
authors.forename: Javier
authors.initials: J
authors.lastname: Briones
authors.forename: Salut
authors.initials: S
authors.lastname: Brunet
authors.forename: Carme
authors.initials: C
authors.lastname: Canals
authors.forename: Jorge
authors.initials: J
authors.lastname: Sierra
mesh_terms: 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*
chemical_list: D014168:Transferrin; D005293:Ferritins