Labile plasma iron levels predict survival in patients with lower-risk myelodysplastic syndromes.
Labile plasma iron levels predict survival in patients with lower-risk myelodysplastic syndromes.
复制标题
不稳定的血浆铁水平预测脊髓降临综合征的患者的存活率。
DOI：
10.3324/haematol.2017.171884
复制
发表时间：
2018-01
期刊：
影响因子：
10.1
通讯作者：
EUMDS Steering Committee
中科院分区：
文献类型：
--
作者：
de Swart L;Reiniers C;Bagguley T;van Marrewijk C;Bowen D;Hellström-Lindberg E;Tatic A;Symeonidis A;Huls G;Cermak J;van de Loosdrecht AA;Garelius H;Culligan D;Macheta M;Spanoudakis M;Panagiotidis P;Krejci M;Blijlevens N;Langemeijer S;Droste J;Swinkels DW;Smith A;de Witte T;EUMDS Steering Committee
红细胞输注仍然是骨髓增生异常综合征低风险患者支持性护理的基石之一。我们假设患者通过形成有毒铁物质而发生氧化剂介导的组织损伤，这是由红细胞输注或无效的红细胞生成引起的。我们分析了100例低风险骨髓增生异常综合征患者的血清样本，每隔6个月检测转铁蛋白饱和度、铁调素-25、生长分化因子15、可溶性转铁蛋白受体、非转铁蛋白结合铁和不稳定血浆铁，以评估铁代谢的时间变化和潜在毒性铁物质的存在及其对生存的影响。与66例无环形铁粒幼细胞的患者相比，34例环形铁粒幼细胞的铁调素水平较低。铁调素和非转铁蛋白结合铁水平的增加在所有输血依赖性患者组的随访早期可见。在具有环形铁粒幼细胞的输血非依赖性患者中，铁调素水平随时间显著降低。增加可溶性转铁蛋白受体水平的输血非依赖性患者与环形铁粒幼细胞证实存在无效的红细胞生成和铁调素生产的抑制，在这些患者。可检测的不稳定血浆铁水平与高转铁蛋白饱和度水平相结合，几乎完全发生在环形铁粒幼细胞和所有输血依赖性患者组。在无环形铁粒幼细胞的输血依赖患者中，可检测到的不稳定血浆铁水平与生存率降低相关。总之，毒性铁物种发生在所有输血依赖性患者和输血非依赖性环状铁粒幼细胞患者。不稳定的血浆铁似乎是一个潜在的铁毒性的临床相关措施和输血依赖患者生存的预后因素。clinicaltrials.gov标识符：00600860。
Red blood cell transfusions remain one of the cornerstones in supportive care of lower-risk patients with myelodysplastic syndromes. We hypothesized that patients develop oxidant-mediated tissue injury through the formation of toxic iron species, caused either by red blood cell transfusions or by ineffective erythropoiesis. We analyzed serum samples from 100 lower-risk patients with myelodysplastic syndromes at six-month intervals for transferrin saturation, hepcidin-25, growth differentiation factor 15, soluble transferrin receptor, non-transferrin bound iron and labile plasma iron in order to evaluate temporal changes in iron metabolism and the presence of potentially toxic iron species and their impact on survival. Hepcidin levels were low in 34 patients with ringed sideroblasts compared to 66 patients without. Increases of hepcidin and non-transferrin bound iron levels were visible early in follow-up of all transfusion-dependent patient groups. Hepcidin levels significantly decreased over time in transfusion-independent patients with ringed sideroblasts. Increased soluble transferrin receptor levels in transfusion-independent patients with ringed sideroblasts confirmed the presence of ineffective erythropoiesis and suppression of hepcidin production in these patients. Detectable labile plasma iron levels in combination with high transferrin saturation levels occurred almost exclusively in patients with ringed sideroblasts and all transfusion-dependent patient groups. Detectable labile plasma iron levels in transfusion-dependent patients without ringed sideroblasts were associated with decreased survival. In conclusion, toxic iron species occurred in all transfusion-dependent patients and in transfusion-independent patients with ringed sideroblasts. Labile plasma iron appeared to be a clinically relevant measure for potential iron toxicity and a prognostic factor for survival in transfusion-dependent patients. clinicaltrials.gov Identifier: 00600860.
登录
查看更多内容
影响因子：
20.3
作者：
Gardenghi, Sara;Marongiu, Maria F.;Rivella, Stefano
通讯作者：
Rivella, Stefano
影响因子：
20.3
作者：
Esposito, BP;Breuer, W;Cabantchik, ZI
通讯作者：
Cabantchik, ZI
影响因子：
3
作者：
Evans, Robert W.;Rafique, Roozina;Hider, Robert C.
通讯作者：
Hider, Robert C.
影响因子：
20.3
作者：
Girelli, Domenico;Nemeth, Elizabeta;Swinkels, Dorine W.
通讯作者：
Swinkels, Dorine W.
影响因子：
3.1
作者：
Ghoti, Hussam;Amer, Johnny;Fibach, Eitan
通讯作者：
Fibach, Eitan