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Transfusion-associated iron overload as an adverse risk factor for transplantation outcome in patients undergoing reduced-intensity stem cell transplantation for myeloid malignancies

Authors
 Kim YR  ;  Kim JS  ;  Cheong JW  ;  Song JW  ;  Min YH 
Citation
 ACTA HAEMATOLOGICA, Vol.120(3) : 182-189, 2008 
Journal Title
 ACTA HAEMATOLOGICA 
ISSN
 0001-5792 
Issue Date
2008
MeSH
Adolescent ; Adult ; Erythrocyte Transfusion* ; Female ; Ferritins/blood* ; Hematologic Neoplasms/blood* ; Hematologic Neoplasms/mortality ; Hematologic Neoplasms/therapy* ; Hematopoietic Stem Cell Transplantation* ; Humans ; Iron Chelating Agents/therapeutic use ; Iron Overload/blood* ; Iron Overload/drug therapy ; Iron Overload/etiology ; Iron Overload/mortality ; Male ; Middle Aged ; Risk Factors
Keywords
Iron overload ; Transfusion ; Reduced-intensity stem cell transplantation
Abstract
Transfusion-associated iron overload could be an important risk factor in myeloablative hematopoietic stem cell transplantation. However, few studies have evaluated the effect of iron overload in reduced-intensity stem cell transplantation (RIST). We evaluated 38 patients with myeloid malignancies, 16 with and 22 without iron overload, who received RIST. We used pretransplant serum ferritin as a marker of iron overload. There was a positive correlation between the number of transfused packed red blood cells and pretransplant serum ferritin levels (21.5 units and 1,578.7 microg/l in the iron overload group vs. 12 units and 739.3 microg/l in the iron non-overload group; p <0.01). Engraftment day and chimerism analysis were not affected by iron overload (p = 0.71 and 0.47, respectively). There were no differences in treatment-related mortality (p = 0.94), veno-occlusive disease (p = 0.99), acute and chronic graft versus host disease (p = 0.58 and 0.99, respectively) according to iron overload. There was a significant difference in disease-free and overall survival (35.8 and 27% in the iron overload group vs. 80.6 and 54.6% in the iron non-overload group; p = 0.01 and 0.03, respectively). We conclude that transfusion-associated iron overload is an adverse risk factor in RIST for myeloid malignancies. The clinical outcomes according to iron overload in RIST were different in myeloablative hematopoietic stem cell transplantation. A serial follow-up of serum ferritin level and judicious iron chelation therapy will be needed to manage the side effect of iron overload in RIST and improve transplantation outcomes
Full Text
http://www.karger.com/Article/FullText/187646
DOI
10.1159/000187646
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, 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
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/22282913/108453
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