title: Clinical significance of pre- and 1-year post-transplant serum ferritin among adult transplant recipients.
abstract: To clarify the significance of post-transplant serum ferritin (SF), we retrospectively assessed pre- and post-transplant SF. Among 256 patients undergoing allogeneic stem cell transplant (SCT) for hematologic malignancies between 2000 and 2011, those who had relapsed within 1 year were excluded, and 110 patients surviving for more than 1 year were included in the analysis. The cut-off value of SF was 1000 ng/mL, and four pre- and post-SF groups were defined: low-low (n = 62), low-high (n = 12), high-low (n = 13) and high-high (n = 23). Outcomes at 5 years for each group were as follows: overall survival (OS) 88.2, 38.1, 92.3 and 76.7%, respectively, p = 0.004, and non-relapse mortality (NRM) 11.3, 53.6, 7.7 and 18.9%, respectively, p = 0.037. Patients receiving larger transfusion volumes or developing chronic graft-versus-host disease (GVHD) demonstrated higher 1-year SF values. In multivariate analysis for OS and NRM, low-high SF remained a significant predictor of OS (hazard ratio [HR] = 3.49, 95% confidence interval [CI]: 1.10-11.0, p = 0.032) and NRM (HR = 2.95, 95%CI: 1.04-8.36, p = 0.041). These results suggest that the elevation of SF at 1 year after SCT, which may reflect transfusion and the development of chronic GVHD, may have an aggravating influence on outcomes after SCT. This study provides a clue to clarifying the clinical significance of SF in a transplant setting.
authors.affiliation: Department of Hematology, Kanagawa Cancer Center , Yokohama , Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tachibana
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Tanaka
authors.forename: Ayumi
authors.initials: A
authors.lastname: Numata
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Naoto
authors.initials: N
authors.lastname: Tomita
authors.forename: Katsumichi
authors.initials: K
authors.lastname: Fujimaki
authors.forename: Jun
authors.initials: J
authors.lastname: Taguchi
authors.forename: Rika
authors.initials: R
authors.lastname: Sakai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujita
authors.forename: Shin
authors.initials: S
authors.lastname: Fujisawa
authors.forename: Atsuo
authors.initials: A
authors.lastname: Maruta
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ishigatsubo
authors.forename: Heiwa
authors.initials: H
authors.lastname: Kanamori
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005293:Ferritins / Q000097:blood*; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control; D019337:Hematologic Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012189:Retrospective Studies; D066027:Transplant Recipients; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005293:Ferritins
keywords: Post-transplant serum ferritin; allogeneic stem cell transplant