title: Increased Bone Marrow Iron Scores Are Strongly Correlated With Elevated Serum Ferritin Levels and Poorer Survival in Patients With Iron Overload That Underwent Allogeneic Hematopoietic Stem Cell Transplantation: A Single Center Experience.
abstract: Iron overload is one of the most significant problems as a leading cause of death in patients with leukemia and those who underwent allogeneic hematopoietic stem cell transplantation (alloHSCT).
  
  
  
  In the current study, we retrospectively evaluated the bone marrow iron scores (BMIS) in patients who underwent alloHSCT (n = 125). The first available bone marrow biopsy specimens prior to the alloHSCT procedure or date of hospitalization (control group) were assessed in a blinded fashion using a standardized scoring system.
  
  
  
  A total of 125 patients were enrolled in the study. Seventy-six (60.8%) of the patients were male, and 49 (39.2%) were female. The median level of pre-transplant serum ferritin was 1023.00 ng/mL (range, 393.80-1627.50 ng/mL). The majority of the patients were diagnosed with acute leukemia (83; 66.4%) and lymphomas (20; 16.0%). The median time for neutrophil engraftment was 14.00 days (range, 13.00-16.00 days) and 11.00 days (range, 10.00-14.00 days) for platelet engraftment. The peri-transplant mortality was similar to international mortality rates (3; 2.4%). The overall survival and disease-free survival were strongly correlated with the degree of BMIS, and both were significantly poorer in patients with high bone marrow iron content (P < .001 and P = .012, respectively).
  
  
  
  The validation of BMIS for risk stratification in patients who undergo alloHSCT may predict posttransplant outcomes.
authors: Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey. Electronic address: drssivgin@gmail.com.
authors: Serdar
authors: S
authors: Sivgin
authors: Department of Pathology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Sinan
authors: S
authors: Nazlim
authors: Department of Biostatistics, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Gokmen
authors: G
authors: Zararsiz
authors: Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Osman
authors: O
authors: Baspinar
authors: Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Leylagul
authors: L
authors: Kaynar
authors: Department of Pathology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Kemal
authors: K
authors: Deniz
authors: Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Mustafa
authors: M
authors: Cetin
authors: Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Ali
authors: A
authors: Unal
authors: Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Bulent
authors: B
authors: Eser
mesh_terms: D000328:Adult; D015415:Biomarkers; D001706:Biopsy; D001853:Bone Marrow / Q000378:metabolism*; D005260:Female; D005293:Ferritins / Q000097:blood*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007501:Iron / Q000378:metabolism*; D019190:Iron Overload / Q000209:etiology / Q000378:metabolism* / Q000401:mortality*; D053208:Kaplan-Meier Estimate; D007938:Leukemia / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005293:Ferritins; D007501:Iron
keywords: AlloHSCT; Bone marrow; Ferritin; Iron overload; Survival