Iron overload might increase transplant-related mortality in haematopoietic stem cell transplantation
Iron overload might increase transplant-related mortality in haematopoietic stem cell transplantation
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DOI：
10.1038/sj.bmt.1703570
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发表时间：
2002-06-01
影响因子：
4.8
通讯作者：
Gimferrer, E
中科院分区：
文献类型：
--
作者：
Altès, A;Remacha, AF;Gimferrer, E
铁超载（IO）与自由基的产生和组织损伤有关。我们的主要目的是确定在预处理过程中，极高水平的铁蛋白（大于或等于3000 μ g/l）和转铁蛋白饱和度（TS）大于或等于100%是否对造血干细胞移植（HSCT）后的总生存率（OS）和移植相关死亡率（TRM）有影响。在CY/TBI后接受HSCT的25例患者中，分别在第-7天和第-4天测量铁蛋白和TS水平。该小组由20名男性和5名女性组成，平均年龄为40岁。15例为自体移植，10例为同种异体移植。其中AL 9例，CML 6例，淋巴瘤10例。其中13例为早期，12例为晚期。在单变量生存分析中，铁蛋白VHL和TS ≥ 100%与OS降低（分别为P = 0.001和P = 0.006）和TRM增加（分别为P = 0.003和P = 0.004）相关。在多变量分析中，这两个变量对OS仍具有显著性（分别为P = 0.03和0.02），TS是TRM的独立因素（P = 0.01）。在多变量分析中，铁蛋白非常接近于达到TRM的统计学显著性（P = 0.06）。总之，预处理时铁蛋白VHL和TS大于或等于100%与移植后中毒性死亡增加相关。
Iron overload (IO) is associated with free radical generation and tissue damage. Our main objective was to ascertain if very high levels (VHL) of ferritin (greater than or equal to3000 mug/l) and transferrin saturation (TS) greater than or equal to100% during conditioning had an impact on overall survival (OS) and transplant-related mortality (TRM) after a haematopoietic stem cell transplantation (HSCT). Levels of ferritin and TS were measured at days -7 and -4, respectively, in 25 patients who underwent HSCT after CY/TBI. The group consisted of 20 men and five women with a median age of 40 years. Fifteen patients were autotransplanted and 10 allotransplanted. Nine of them had a diagnosis of AL, six of CML and 10 of lymphoma. Thirteen of them were in early and 12 in advanced status of disease. VHL of ferritin and TS greater than or equal to100% were associated with a decreased OS (P = 0.001 and P = 0.006, respectively) and an increased TRM (P = 0.003 and P = 0.004, respectively) in univariate survival analysis. Both variables remained significant at multivariate analysis for OS (P = 0.03 and 0.02, respectively) and TS was an independent factor for TRM (P = 0.01). Ferritin was very close to achieving statistical significance for TRM (P = 0.06) in multivariate analysis. In conclusion, VHL of ferritin and TS greater than or equal to100% at conditioning are associated with an increase in toxic deaths after transplant.