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.
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.
Wahlin
Anders
A
Department of Radiation Sciences, University of Umeå, Umeå, Sweden. anders.wahlin@vll.se
Lorenz
Fryderyk
F
Fredriksson
Maritha
M
Remberger
Mats
M
Wahlin
Björn E
BE
Hägglund
Hans
H
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
D005293:Ferritins
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