title: Pretransplant serum ferritin level may be a predictive marker for outcomes in patients having undergone allogeneic hematopoietic stem cell transplantation.
abstract: Iron overload increases the risk of infections, veno-occlusive disease and hepatic dysfunction in post-transplant period. Our objective was to investigate the association of pre-transplant ferritin levels with complications and survival after allogeneic hematopoietic stem cell transplantation (alloHSCT).We retrospectively analysed 84 patients' data who had undergone allogeneic HSCT into two groups: patients with a serum ferritin level ≥ 1000 ng/ml, and patients with <1000 ng/ml at the time of HSCT.Cox-regression analysis showed that pre-transplant serum ferritin levels were significantly higher in patients who had at least one infectious event compared with those who had no any infectious event in the post-transplant 100 days (p<0.023). Overall survival (OS) and disease-free survival (DFS) rates were significantly higher in patients with a time-to-tx interval 12 months (p=0.002 and p=0.008 respectively). A higher risk of death was observed in high-ferritin group (hazard ratio=2.27, CI:1.01-5.09, p=0.023 for OS and hazard ratio=2.49, CI:1.12-5.53 p=0.039 for DFS). No significant effect on OS and DFS among groups was observed for variables conditioning regimen, gender and diagnosis. Acute GVHD was more common in patients with a ferritin level ≥ 1000 ng /mL, but this was not statistically significant (p>0.05). There was no statistical significance in both groups (ferritin ≥ 1000 ng /mL and ferritin <1000 ng/mL) for relapse rates (p>0.05). Platelet and neutrophil engaftment day was not found statistically significant compared with both groups (p=0.273 and p=0.882, respectively). Pre-transplant ferritin levels may predict poor outcomes in patients who had undergone allogeneic hematopoietic stem cell transplantation.
authors.affiliation: Dedeman Stem Cell Transplantation Hospital, Department of Hematology, Erciyes University, Kayseri, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Sivgin
authors.forename: S
authors.initials: S
authors.lastname: Baldane
authors.forename: L
authors.initials: L
authors.lastname: Kaynar
authors.forename: F
authors.initials: F
authors.lastname: Kurnaz
authors.forename: C
authors.initials: C
authors.lastname: Pala
authors.forename: A
authors.initials: A
authors.lastname: Ozturk
authors.forename: M
authors.initials: M
authors.lastname: Cetin
authors.forename: A
authors.initials: A
authors.lastname: Unal
authors.forename: B
authors.initials: B
authors.lastname: Eser
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005293:Ferritins / Q000097:blood*; D006086:Graft vs Host Disease / Q000097:blood / Q000209:etiology / Q000401:mortality*; D019337:Hematologic Neoplasms / Q000150:complications / Q000401:mortality* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007239:Infections / Q000097:blood / Q000209:etiology; D019190:Iron Overload / Q000097:blood / Q000209:etiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005293:Ferritins