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Transfusion-associated iron overload as a predictive factor for poor stem cell mobilization in patients with haematological malignancies

Authors
 I. H. Park  ;  Y. Kim  ;  J. S. Kim  ;  J.-W. Cheong  ;  J. W. Song  ;  Y. H. Min 
Citation
 TRANSFUSION MEDICINE, Vol.18(2) : 97-103, 2008 
Journal Title
 TRANSFUSION MEDICINE 
ISSN
 0958-7578 
Issue Date
2008
MeSH
Adolescent ; Adult ; Aged ; Antigens, CD34/blood ; Flow Cytometry ; Hematologic Neoplasms/blood* ; Hematopoietic Stem Cell Mobilization/methods* ; Humans ; Iron Overload/etiology* ; Leukapheresis ; Middle Aged ; Patient Selection ; Predictive Value of Tests ; Retrospective Studies ; Transfusion Reaction* ; Treatment Outcome
Keywords
iron overload ; stem cell mobilization ; transfusion
Abstract
Transfusion-associated iron overload is often observed in patients with haematological malignancies. We analysed the effect of iron overload, indicated by high serum ferritin level, on the mobilization of CD34(+) peripheral blood stem cells (PBSCs). We evaluated the association between the serum ferritin level prior to PBSC collection and the number of CD34(+) cells collected through leukapheresis in 51 patients with various haematological malignancies. Patients with serum ferritin level over 1000 ng mL(-1) were defined as high-ferritin group. Comparing the good (> or =1 x 10(6) per kg CD34(+) cells) and poor (<1 x 10(6) per kg CD34(+) cells) mobilizing groups, there was no difference in disease status, previous chemotherapies and white blood cell count at the first day of apheresis. However, there was a significant difference in the median units of red blood cell transfused between the good and poor mobilizer (2 vs. 8 units; P = 0.012). Serum ferritin level was notably higher in the poor mobilizer (1670 +/- 1320 ng mL(-1)) compared with the good mobilizer (965 +/- 705 ng mL(-1), P = 0.035). The cumulative number of CD34(+) cells per kg collected during the whole procedure was significantly lower in the high-ferritin group (5.5 +/- 4.7 x 10(6) per kg vs. 13.1 +/- 9.1 x 10(6) per kg, P = 0.01). Multivariate analysis revealed that serum ferritin level remained as an independent predictive factor for poor PBSC mobilization. Our study indicated that transfusion-associated iron overload is a predictive factor for poor PBSC mobilization. Iron chelation therapy prior to apheresis may be required to collect sufficient numbers of PBSCs in the iron overload patients.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3148.2008.00849.x/abstract
DOI
10.1111/j.1365-3148.2008.00849.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yu Ri(김유리) ORCID logo https://orcid.org/0000-0001-5505-0142
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
Park, In Hae(박인혜)
Song, Jae Woo(송재우) ORCID logo https://orcid.org/0000-0002-1877-5731
Chung, Joo Won(정주원)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107056
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