title: Hyperferritinemia is associated with low incidence of graft versus  host disease, high relapse rate, and impaired survival in patients  with blood disorders receiving allogeneic hematopoietic stem cell  grafts.
abstract: High pre-transplantation serum ferritin levels have been reported to be associated with impaired survival post-transplantation in patients with acute myeloid leukemia or myelodysplastic syndrome. We performed a retrospective study of 309 patients who underwent allogeneic hematopoietic stem cell transplantation at two transplantation centers. The aim was to determine the effect of pretransplantation hyperferritinemia on survival, graft versus host disease, and relapse. In both univariate and multivariate analysis, elevated ferritin levels were significantly associated with shorter overall and relapse-free survival times and increased relapse rate, but lower risk of chronic graft versus host disease. Elevated ferritin levels were not associated with non-relapse mortality. We hypothesize that ferritin may exert an immunosuppressive effect, reducing graft versus host disease and graft versus leukemia effects, resulting in increased risk of relapse and impaired survival.
authors.affiliation: Department of Radiation Sciences, University of Umeå, Umeå, Sweden. anders.wahlin@vll.se
authors.forename: Anders
authors.initials: A
authors.lastname: Wahlin
authors.forename: Fryderyk
authors.initials: F
authors.lastname: Lorenz
authors.forename: Maritha
authors.initials: M
authors.lastname: Fredriksson
authors.forename: Mats
authors.initials: M
authors.lastname: Remberger
authors.forename: Björn E
authors.initials: BE
authors.lastname: Wahlin
authors.forename: Hans
authors.initials: H
authors.lastname: Hägglund
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005293:Ferritins / Q000097:blood*; D006086:Graft vs Host Disease / Q000097:blood* / Q000453:epidemiology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000097:blood* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood* / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000097:blood; D016016:Proportional Hazards Models; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D005293:Ferritins
references.citation: Blood. 2002 May 1;99(9):3326-34
references.pmid: 11964300
references.citation: Blood. 1997 Aug 1;90(3):994-8
references.pmid: 9242528
references.citation: Am J Med. 1980 Aug;69(2):204-17
references.pmid: 6996481
references.citation: Bone Marrow Transplant. 1995 Jun;15(6):825-8
references.pmid: 7581076
references.citation: Bone Marrow Transplant. 2002 Jun;29(12):987-9
references.pmid: 12098067
references.citation: Br J Haematol. 2009 Aug;146(3):310-6
references.pmid: 19508292
references.citation: Biol Blood Marrow Transplant. 2009 Feb;15(2):195-204
references.pmid: 19167679
references.citation: Br J Haematol. 1989 Oct;73(2):260-4
references.pmid: 2554953
references.citation: Immunopharmacol Immunotoxicol. 1995 Nov;17(4):719-32
references.pmid: 8537608
references.citation: Biol Blood Marrow Transplant. 2008 Nov;14(11):1239-44
references.pmid: 18940678
references.citation: Blood. 2007 May 15;109(10):4586-8
references.pmid: 17234738
references.citation: Transplantation. 2006 Oct 15;82(7):913-9
references.pmid: 17038906
references.citation: Bone Marrow Transplant. 2008 Dec;42(12):799-805
references.pmid: 18762767
references.citation: J Autoimmun. 2008 Feb-Mar;30(1-2):84-9
references.pmid: 18191543
references.citation: Eur J Haematol. 1991 Apr;46(4):240-7
references.pmid: 2015877
references.citation: Lancet. 1993 Dec 4;342(8884):1388-91
references.pmid: 7901682
references.citation: Br J Haematol. 1979 Jul;42(3):345-53
references.pmid: 157770