title: Impact of hyperferritinemia on the outcome of reduced-intensity conditioning allogeneic hematopoietic cell transplantation for lymphoid malignancies.
abstract: Hyperferritinemia has been associated with adverse outcomes after allogeneic hematopoietic cell transplantation (allo-HCT) with myeloablative conditioning. However, its characteristics and impact on the outcome in the reduced-intensity conditioning (RIC) and in the lymphoid malignancy settings are far from clear. The study includes 201 adult patients undergoing allo-HCT with RIC (allo-RIC) for lymphoid malignancies with a median follow-up for survivors of 52 months (range, 3 to 123). Median serum ferritin level at allo-RIC was 379 ng/mL (range, 4 to 10,790). In the multivariate analysis, patients with hyperferritinemia at transplantation (>399 ng/mL) showed lower 4-year overall survival (hazard ratio [HR], 1.8 [95% confidence interval {CI}, 1.2 to 2.8]; P = .008), higher nonrelapse mortality (NRM) (HR, 1.8 [95% CI, 1.1 to 3.2]; P = .03), and higher infection-related mortality (HR, 2.3 [95% CI, 1.1 to 4.8]; P = .02) than patients without hyperferritinemia. Neutrophil and platelet engraftment and 100-day NRM were similar between both groups. The adverse outcome associated with hyperferritinemia seemed higher in patients without major comorbidities and was not influenced by the elevation of acute phase reactants. Our results indicate that high ferritin levels at HCT are associated with an adverse outcome after allo-RIC in patients with lymphoid malignancies.
authors.affiliation: Hematology Departments of Hospital Universitari Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain. pebarba@vhebron.net
authors.forename: Pere
authors.initials: P
authors.lastname: Barba
authors.forename: David
authors.initials: D
authors.lastname: Valcárcel
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Pérez-Simón
authors.forename: Francesc
authors.initials: F
authors.lastname: Fernández-Avilés
authors.forename: José Luis
authors.initials: JL
authors.lastname: Piñana
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Martino
authors.forename: Lucía
authors.initials: L
authors.lastname: López-Anglada
authors.forename: Montserrat
authors.initials: M
authors.lastname: Rovira
authors.forename: Irene
authors.initials: I
authors.lastname: Garcia-Cadenas
authors.forename: Silvana
authors.initials: S
authors.lastname: Novelli
authors.forename: Enric
authors.initials: E
authors.lastname: Carreras
authors.forename: Lucía
authors.initials: L
authors.lastname: López Corral
authors.forename: Jorge
authors.initials: J
authors.lastname: Sierra
mesh_terms: D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000187:drug effects / Q000276:immunology; D005260:Female; D005293:Ferritins / Q000097:blood*; D005500:Follow-Up Studies; D006085:Graft Survival / Q000187:drug effects / Q000276:immunology; D019337:Hematologic Neoplasms / Q000097:blood / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008558:Melphalan / Q000627:therapeutic use*; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000627:therapeutic use*; D009504:Neutrophils / Q000187:drug effects / Q000276:immunology; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014740:Vidarabine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D019653:Myeloablative Agonists; D005293:Ferritins; D014740:Vidarabine; C024352:fludarabine; D008558:Melphalan