title: Assessment of labile plasma iron in patients who undergo hematopoietic stem cell transplantation.
abstract: Body iron disorders have been reported after myeloablative conditioning in patients undergoing hematopoietic stem cell transplantation (HSCT). There is a concern that labile plasma iron (LPI), the redox-active form of iron, can be involved in the occurrence of toxicity and other complications commonly observed in the early post-HSCT period. In order to better understand the LPI kinetics and its determinants and implications, we undertook sequential LPI determinations before and after conditioning until engraftment in 25 auto-HSCT patients. Increased LPI was present in only 5 patients before starting conditioning. Shortly after conditioning, LPI levels were increased in 23 patients, with peak at day 0, returning to normal range upon engraftment in 21 patients. Overall, LPI levels correlated weakly with serum ferritin and more strongly with transferrin saturation; however, both parameters were apparently not applicable as surrogate markers for increased LPI. Although this was a small cohort, logistic regression suggested that baseline LPI levels could predict occurrence of grade III or IV toxicity. In conclusion, LPI kinetics is influenced by aplasia following conditioning and engraftment. Measuring LPI before starting conditioning can offer an opportunity to predict toxicity and, perhaps, the need for chelation therapy.
authors: Academia de Ciência e Tecnologia, São José do Rio Preto, Brazil.
authors: Flávio Augusto
authors: FA
authors: Naoum
authors: Breno Pannia
authors: BP
authors: Espósito
authors: Lílian Piron
authors: LP
authors: Ruiz
authors: Milton Artur
authors: MA
authors: Ruiz
authors: Paula Yurie
authors: PY
authors: Tanaka
authors: Juliana Tavora
authors: JT
authors: Sobreira
authors: Rodolfo Delfini
authors: RD
authors: Cançado
authors: José Carlos
authors: JC
authors: de Barros
mesh_terms: D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000737:chemistry; D001205:Ascorbic Acid / Q000737:chemistry; D015331:Cohort Studies; D000077543:Deferiprone; D005260:Female; D005456:Fluorescent Dyes / Q000737:chemistry; D005500:Follow-Up Studies; D006085:Graft Survival; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007501:Iron / Q000097:blood* / Q000737:chemistry; D007502:Iron Chelating Agents / Q000737:chemistry; D019190:Iron Overload / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011728:Pyridones / Q000737:chemistry; D012235:Rhodamines / Q000737:chemistry; D012720:Severity of Illness Index; D019172:Transplantation Conditioning / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000975:Antioxidants; D005456:Fluorescent Dyes; D007502:Iron Chelating Agents; D011728:Pyridones; D012235:Rhodamines; D000077543:Deferiprone; D007501:Iron; D001205:Ascorbic Acid