[Effects of pre-immunosupressive therapy iron overload on hematologic response of severe aplastic anemia].
OBJECTIVE
To explore the effects of serum ferritin (SF) and iron overload (IO) pre-immunosupressive treatment (IST) on hematologic response of severe aplastic anemia (SAA/VSAA) patients treated with IST.


METHODS
257 SAA/VSAA patients who underwent first-line IST from Feb, 2003 to Dec, 2011 in Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital were retrospectively analyzed, the status of SF before IST and the IO-affected factors were studied. The effects of IO on hematologic response of SAA/VSAA patients were evaluated as well.


RESULTS
The median level of SF of 257 patients was 387 (6-2 004) μg/L. 36 patients (14%) had IO, including 20 SAA and 16 VSAA patients. According to univariate logistical regression analyses, IO was influenced by age>14 years (P=0.010) and blood transfusion (P<0.001). The multivariate logistic regression analysis showed that blood transfusion [P=0.001, OR=0.218 (95% CI 0.092-0.520)] was the only independent prognostic factor. SAA (but not for VSAA) patients with IO had much lower hematologic response rate in 6 month after IST (P=0.037). Absolute reticulocyte count and IO correlated with response at 6 month by univariate logistical regression analysis (P=0.014, 0.037). The multivariate logistic regression analysis showed that IO [P=0.021, OR=4.092 (95% CI 1.235-13.563)], ARC ≥20×10(9)/L [P=0.040, OR=2.743 (95% CI 1.049-7.175)] were independent prognostic factors.


CONCLUSIONS
84.8% patients had high serum ferritin before IST, and 14.0% reached IO. Adult and more blood transfusion caused IO more likely. IO correlated with response at 6 month, and was independent prognostic factor.
Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
Lei
L
Ye
Liping
L
Jing
Guangxin
G
Peng
Kang
K
Zhou
Yang
Y
Li
Yuan
Y
Li
Jianping
J
Li
Huihui
H
Fan
Wenrui
W
Yang
Fengkui
F
Zhang
Li
L
Zhang
D000328:Adult; D000741:Anemia, Aplastic / Q000188:drug therapy / Q000503:physiopathology*; D001803:Blood Transfusion; D005293:Ferritins / Q000097:blood*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D019190:Iron Overload / Q000503:physiopathology*; D016015:Logistic Models; D017701:Reticulocyte Count; D012189:Retrospective Studies
D007166:Immunosuppressive Agents; D005293:Ferritins