title: Pretransplant serum ferritin is associated with bloodstream infections within 100 days of allogeneic stem cell transplantation for myeloid malignancies.
abstract: We retrospectively studied the association between iron overload and bloodstream infections (BSI) in the 100-day period following allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute myeloid leukemia or myelodysplastic syndromes. Serum ferritin was measured before transplantation to evaluate iron overload. Of 114 adult patients who underwent transplantation between 2000 and 2008, 36 (32%) developed BSI. Of the 44 isolates, 63% were Gram-positive bacteria, 32% were Gram-negative bacteria, and 4% were fungi. The median time to the onset of the first BSI was day 28 (range day 0-95) after transplantation. Univariate analysis revealed a significantly higher incidence of BSI in the high (≥ 1,000 ng/ml, n = 57) than in the low (< 1,000 ng/ml, n = 57) ferritin group (42.1 versus 21.1%, respectively, P = 0.017). Peripheral blood stem cell transplantation (PBSCT) (n = 23) showed a greater protective effect against BSI compared with bone marrow (n = 71) and cord blood (n = 20) transplantation. Pretransplantation serum ferritin (HR = 2.844, 95% CI: 1.180-6.859, P = 0.020) and PBSCT (HR = 0.135, 95% CI: 0.025-0.717, P = 0.019) were significant factors on multivariate analysis. In conclusion, pretransplantation serum ferritin significantly predicts BSI within the 100-day period after allo-HSCT.
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-ku, Yokohama, 241-0815, Japan. tachibanat@kcch.jp.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tachibana
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-ku, Yokohama, 241-0815, Japan.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-ku, Yokohama, 241-0815, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Takasaki
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-ku, Yokohama, 241-0815, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Numata
authors.affiliation: Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Satomi
authors.initials: S
authors.lastname: Ito
authors.affiliation: Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Reina
authors.initials: R
authors.lastname: Watanabe
authors.affiliation: Department of HSCT Data Management and Biostatistics, Nagoya University, School of Medicine, Nagoya, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Hyo
authors.affiliation: Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Ohshima
authors.affiliation: Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Hagihara
authors.affiliation: Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Sakai
authors.affiliation: Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Fujisawa
authors.affiliation: Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Tomita
authors.affiliation: Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujita
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-ku, Yokohama, 241-0815, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Maruta
authors.affiliation: Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ishigatsubo
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-ku, Yokohama, 241-0815, Japan.
authors.forename: Heiwa
authors.initials: H
authors.lastname: Kanamori
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000097:blood*; D005260:Female; D005293:Ferritins / Q000097:blood*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000097:blood*; D009190:Myelodysplastic Syndromes / Q000097:blood* / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D014184:Transplantation, Homologous
chemical_list: D005293:Ferritins