title: The prognostic role of hemochromatosis H63D allele in allogeneic hematopoietic stem cell transplantation.
abstract: Iron overload is considered as a significant cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients. The presence of hemochromatosis gene (HFE) mutations might exacerbate iron toxicity in the post-transplant setting. This prospective study was planned to evaluate the genetic spectrum of HFE mutations in Turkish patients undergoing HSCT and the impact of HFE genotype on transplant morbidity and mortality. HFE genotypes of 102 patients [median age, 27.5 years (16-64 years); male/female, 73:29], who underwent allogeneic HSCT, were analyzed. Twenty-two patients were heterozygous and 1 patient was homozygous for the H63D mutation, while the C282Y mutation was observed in none of our patients. The frequency of invasive fungal infections (IFI) was significantly higher in H63D-mutated patients (p=0.004). H63D mutation was identified as an independent risk factor for the development of IFI (p=0.006, OR=0.554, SE=0.208), without an impact on overall survival and transplant-related mortality. The multifactorial iron-overloaded state in HSCT recipients might affect the phenotypic expression of HFE mutations and alter the severity of clinical presentation. The impact of HFE genotype on iron parameters and transplant-related morbidity and mortality should be validated with further studies.
authors.affiliation: Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Gülsan Türköz
authors.initials: GT
authors.lastname: Sucak
authors.forename: Demet Gökalp
authors.initials: DG
authors.lastname: Yaşar
authors.forename: Zeynep Arzu
authors.initials: ZA
authors.lastname: Yegin
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Ergün
authors.forename: Zübeyde Nur
authors.initials: ZN
authors.lastname: Ozkurt
authors.forename: Şahika Zeynep
authors.initials: ŞZ
authors.lastname: Aki
authors.forename: Sezen
authors.initials: S
authors.lastname: Güntekin
mesh_terms: D000293:Adolescent; D000328:Adult; D000483:Alleles; D019943:Amino Acid Substitution / Q000235:genetics / Q000502:physiology; D001224:Aspartic Acid / Q000235:genetics; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D000071020:Hemochromatosis Protein; D006639:Histidine / Q000235:genetics; D015395:Histocompatibility Antigens Class I / Q000032:analysis / Q000235:genetics* / Q000502:physiology; D006801:Humans; D019190:Iron Overload / Q000175:diagnosis* / Q000235:genetics; D008297:Male; D008565:Membrane Proteins / Q000032:analysis / Q000235:genetics* / Q000502:physiology; D008875:Middle Aged; D011379:Prognosis; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins; D001224:Aspartic Acid; D006639:Histidine