Prognostic impact of elevated pretransplantation serum ferritin in patients undergoing myeloablative stem cell transplantation

• Published in: Blood Vol. 109; no. 10; pp. 4586 - 4588
• Main Authors: Armand, Philippe, Kim, Haesook T., Cutler, Corey S., Ho, Vincent T., Koreth, John, Alyea, Edwin P., Soiffer, Robert J., Antin, Joseph H.
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 15.05.2007; The Americain Society of Hematology; American Society of Hematology
• Series: Transplantation
• Subjects: Albumins - physiology; Biological and medical sciences; Ferritins - blood; Hematologic and hematopoietic diseases; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - mortality; Hepatic Veno-Occlusive Disease - etiology; Humans; Immunosuppression - mortality; Iron Overload - etiology; Medical sciences; Myelodysplastic Syndromes - blood; Myelodysplastic Syndromes - diagnosis; Myelodysplastic Syndromes - mortality; Myelodysplastic Syndromes - therapy; Myeloproliferative Disorders - blood; Myeloproliferative Disorders - diagnosis; Myeloproliferative Disorders - mortality; Myeloproliferative Disorders - therapy; Prognosis; Recurrence; Retrospective Studies; Serologic Tests; Survival Analysis; Transplantation; Human; Prognosis; Hematology; Stem cell; Ferritin; Hematopoietic cell; Graft; Myelosuppression; Serum
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2006-10-054924

Iron overload could be a significant contributor to treatment-related mortality (TRM) for patients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT). We studied 590 patients who underwent myeloablative allogeneic HSCT at our institution, and on whom a pretransplantation serum ferritin was available. An elevated pretransplantation serum ferritin level was strongly associated with lower overall and disease-free survival. Subgroup multivariable analyses demonstrated that this association was restricted to patients with acute leukemia or myelodysplastic syndrome (MDS); in the latter group, the inferior survival was attributable to a significant increase in TRM. There was also a trend toward an increased risk of veno-occlusive disease in patients with high ferritin. Our results argue that iron overload plays an important role in transplantation outcome for patients with acute leukemia or MDS, as it does in thalassemia. They also suggest future prospective trials to examine the potential benefit of chelation therapy in this setting.