Prognostic impact of elevated pretransplantation serum ferritin in patients undergoing myeloablative stem cell transplantation
Prognostic impact of elevated pretransplantation serum ferritin in patients undergoing myeloablative stem cell transplantation
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DOI：
10.1182/blood-2006-10-054924
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发表时间：
2007-05-15
期刊：
影响因子：
20.3
通讯作者：
Antin, Joseph H.
中科院分区：
文献类型：
--
作者：
Armand, Philippe;Kim, Haesook T.;Antin, Joseph H.
铁超载可能是接受造血干细胞移植（HSCT）的恶性血液病患者治疗相关死亡率（TRM）的重要因素。我们研究了590例在我们机构接受清髓性异基因HSCT的患者，这些患者在移植前血清铁蛋白可用。移植前血清铁蛋白水平升高与总生存率和无病生存率降低密切相关。亚组多变量分析表明，这种关联仅限于急性白血病或骨髓增生异常综合征（MDS）患者;在后一组中，较差的生存率归因于TRM的显著增加。高铁蛋白患者发生静脉闭塞性疾病的风险也有增加的趋势。我们的研究结果表明，铁超载在急性白血病或MDS患者的移植结果中起着重要作用，就像在地中海贫血中一样。他们还建议未来的前瞻性试验，以检查螯合治疗在这种情况下的潜在好处。
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.