title: Hyperferritinemia after adult allogeneic hematopoietic cell transplantation: quantification of iron burden by determining non-transferrin-bound iron.
abstract: Iron overload is a common complication in allogeneic hematopoietic cell transplantation (HCT). We studied the prevalence of iron overload using serum ferritin from 122 allogeneic HCT survivors who had survived a median of 1259 (range 134-4261) days. We also quantified iron overload by determining non-transferrin-bound iron (NTBI), which reflects iron overload more directly than ferritin, and compared the results with those of the ferritin assay. Fifty-two patients (43 %) showed hyperferritinemia (HF) (serum ferritin >1000 ng/mL), and there was a moderate correlation between serum ferritin and the number of transfused red blood cell units (ρ = 0.71). In multivariate analyses, HF was a significant risk factor for liver dysfunction (P = 0.0001) and diabetes (P = 0.02), and was related to a lesser extent with performance status (P = 0.08). There was a significant correlation between serum ferritin and NTBI (ρ = 0.59); however, the association of NTBI with these outcomes was weaker than that of serum ferritin. In conclusion, serum ferritin is a good surrogate marker of iron overload after allogeneic HCT, and reflects organ damage more accurately than NTBI.
authors.affiliation: Department of Hematology, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, Japan. gotot@gf7.so-net.ne.jp
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Goto
authors.forename: Katsuya
authors.initials: K
authors.lastname: Ikuta
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inamoto
authors.forename: Sonoko
authors.initials: S
authors.lastname: Kamoshita
authors.forename: Emi
authors.initials: E
authors.lastname: Yokohata
authors.forename: Daisuke
authors.initials: D
authors.lastname: Koyama
authors.forename: Koichi
authors.initials: K
authors.lastname: Onodera
authors.forename: Aika
authors.initials: A
authors.lastname: Seto
authors.forename: Keisuke
authors.initials: K
authors.lastname: Watanabe
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Imahashi
authors.forename: Shokichi
authors.initials: S
authors.lastname: Tsukamoto
authors.forename: Yukiyasu
authors.initials: Y
authors.lastname: Ozawa
authors.forename: Katsunori
authors.initials: K
authors.lastname: Sasaki
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ito
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kohgo
authors.forename: Koichi
authors.initials: K
authors.lastname: Miyamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005293:Ferritins / Q000097:blood*; D006402:Hematologic Diseases / Q000097:blood / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007501:Iron / Q000097:blood* / Q000378:metabolism; D019190:Iron Overload / Q000097:blood* / Q000175:diagnosis / Q000209:etiology*; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005293:Ferritins; D007501:Iron