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

Yu Ri Kim, Jinseok Kim, June Won Cheong, Jae Woo Song, Yoo Hong Min

Research output: Contribution to journalArticle

24 Citations (Scopus)

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 μg/l in the iron overload group vs. 12 units and 739.3 μg/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.

Original languageEnglish
Pages (from-to)182-189
Number of pages8
JournalActa Haematologica
Volume120
Issue number3
DOIs
Publication statusPublished - 2009 Jan 1

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Iron Overload
Stem Cell Transplantation
Transplantation
Neoplasms
Ferritins
Hematopoietic Stem Cell Transplantation
Serum
Chelation Therapy
Chimerism
Graft vs Host Disease
Disease-Free Survival
Iron

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

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title = "Transfusion-associated iron overload as an adverse risk factor for transplantation outcome in patients undergoing reduced-intensity stem cell transplantation for myeloid malignancies",
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 μg/l in the iron overload group vs. 12 units and 739.3 μg/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.",
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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. / Kim, Yu Ri; Kim, Jinseok; Cheong, June Won; Song, Jae Woo; Min, Yoo Hong.

In: Acta Haematologica, Vol. 120, No. 3, 01.01.2009, p. 182-189.

Research output: Contribution to journalArticle

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AU - Kim, Jinseok

AU - Cheong, June Won

AU - Song, Jae Woo

AU - Min, Yoo Hong

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