Elevation of Serum Ferritin is Associated with the Outcome of Patients with Newly Diagnosed Multiple Myeloma

Abstract

Background/AimsSerum ferritin is a marker of acute phase reactions and iron storage. In addition, hematologic malignancies are associated with elevated serum ferritin levels. Other studies have suggested that ferritin is a surrogate for advanced disease and has an impact on relapse, because elevated serum ferritin predicts overall survival (OS) and relapse-free survival following autologous stem cell transplantation for lymphomas.MethodsWe studied 89 consecutive patients with newly diagnosed multiple myeloma to determine the value of serum ferritin in comparison with known prognostic factors.ResultsThe OS in the elevated serum ferritin group (≥300 ng/mL) was shorter than that in the normal serum ferritin group (<300 ng/mL, p<0.001) after a median follow-up of 25 months. In univariate analysis, elevated ferritin was correlated with poor survival in the patients (relative risk [RR], 2.588; 95% confidence interval [CI], 1.536 to 4.358; p<0.001). Furthermore, multivariate analysis showed that elevated serum ferritin was an independent predictor of mortality in patients with multiple myeloma (RR, 2.594; 95% CI, 1.403 to 4.797; p=0.002).ConclusionsThe serum ferritin can a prognostic parameter of survival as well as disease activity in patients with multiple myeloma.

Pre-treatment blood inflammatory markers as predictors of systemic infection during induction chemotherapy: results of an exploratory study in patients with acute myeloid leukemia

“…It has been accepted in some areas of medicine, including in the prediction of vascular diseases [12,13], and in the field of oncology, anticipating inferior survival in advanced cancers [14]. Likewise, serum ferritin, an acute phase reactant [15], is an indicator of iron overload after repetitive packed red cell transfusion [16] and a biomarker of poor prognosis in patients with several hematologic malignancies [17][18][19]. However, the prognostic implication of these inflammatory markers in patients with acute leukemia seems inappropriate because the treatment of acute leukemia consists of the administration of high-dose chemotherapy and, in selected patients, HSCT.…”

Iron Overload Pattern in Multiple Myeloma at Diagnosis its Important Clinical Associations

“…In their study, elevated ferritin was correlated with poor survival and was an independent predictor of mortality in MM (p= 0.002). 4 They observed an association between increased ferritin level and advanced ISS stage. However, they did not report on other serum iron tests, possible mechanisms of elevated ferritin in MM patients and the association between serum iron parameters and type of myeloma.…”

“…However, increased TS is not compatible with acute phase response. Additionally, serum iron level was frequently borderline high to increased in the IOP cohort which 4 studied the importance of serum ferritin in 89 patients with newly diagnosed MM. They observed that the overall survival in the elevated serum ferritin group was shorter than that in the normal serum ferritin group (p< 0.001) after a median follow-up of 25 months.…”

“…[1][2][3] The serum ferritin was suggested to be a prognostic parameter of survival as well as disease activity in patients with MM. 4 The potential role of the iron in bortezomib-resistance has also been suggested. 5 Likewise, targeting the human transferrin receptor 1 (CD71) may be effective in the potential experimental therapy in human MM.…”

Significance of extremely elevated ferritin level in medical inpatients

“…More modest elevations of ferritin levels of 300 ng/ mL and above have been associated with increased mortality in the setting of multiple myeloma [9] and childhood neuroblastoma [10]. In lung cancer patients ferritin values above 300 ng/mL were significant predictors of survival even adjustment for covariates such as performance status, age, sex, TNM stage, and histological tumor type [11].…”