Iron Overload and Platelet Function Defects

Dahi, Abdulkader Ahmed M; Hanafy, Ehab; Pakra, Mohammed Al

doi:10.1177/2324709616675645

Cited by 9 publications

(9 citation statements)

References 21 publications

(20 reference statements)

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“…17,18,[26][27][28] There is some evidence that iron or ferritin has suppressive effects on hematopoietic cell proliferation and differentiation. [29][30][31] Furthermore, a possible correlation between iron overload and the defect in platelet function was explained by Dahi et al 32 In addition to direct impact, ferritin may have indirect effects on thrombocytopenia through pro-inflammatory roles. 33 Ferritin can trigger TIM-2 (immunoglobulin-domain and mucin-domain-2)-independent pathway (including PI3 kinase phosphorylation, protein kinase C zeta activation, and MAPK activation) that ultimately activates nuclear factor-kB (NF-kB).…”

Section: Discussionmentioning

confidence: 99%

Predicting chemotherapy-induced thrombocytopenia in cancer patients with solid tumors or lymphoma

Razzaghdoust

Mofid

Zangeneh

2019

J Oncol Pharm Pract

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Purpose Chemotherapy-induced thrombocytopenia is a serious complication in chemotherapy-treated patients. Identification of patients at risk for chemotherapy-induced thrombocytopenia could have clinical value in personalized management of patients and optimized administration of prophylactic thrombopoietic agents. The aim of this study was to develop a predictive model for chemotherapy-induced thrombocytopenia (platelet count < 100,000/µl) in cancer patients undergoing chemotherapy. Methods A total of 14 covariates were prospectively assessed as explanatory variables in a cohort of consecutive patients with solid tumors or lymphoma. A multivariable logistic regression model was developed after univariable analysis. A bootstrapping technique was applied for internal validation. Results Data from 305 patients during 1732 chemotherapy cycles were considered for analysis. Forty-eight patients (15.73%) developed chemotherapy-induced thrombocytopenia during their treatment course. The multivariable model exhibited three final predictors for chemotherapy-induced thrombocytopenia, including high ferritin (odds ratio, 4.41; bootstrap P = 0.001), estimated glomerular filtration rate <60 ml/min/1.73 m2 (odds ratio, 3.08; bootstrap P = 0.005), and body mass index <23 kg/m2 (odds ratio, 2.23; bootstrap P = 0.044). The main characteristics of the model include sensitivity 75%, specificity 65.4%, positive likelihood ratio 2.16, and negative likelihood ratio 0.382. Moreover, the model was well calibrated (Hosmer–Lemeshow P = 0.713) and the area under the receiver operating characteristic curve was 0.735 (95% confidence interval, 0.654–0.816; P < 0.001). Conclusions We developed a predictive model for chemotherapy-induced thrombocytopenia based on readily available and easily assessable clinical and laboratory factors. This study may provide a valuable insight to guide optimized treatment of cancer patients. Further studies with larger sample size are warranted.

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Section: Discussionmentioning

confidence: 99%

Predicting chemotherapy-induced thrombocytopenia in cancer patients with solid tumors or lymphoma

Razzaghdoust

Mofid

Zangeneh

2019

J Oncol Pharm Pract

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“…17 Although some studies revealed no agranulocytosis events 14,28 other reports have documented the correlation between acquired platelet defect and iron overload. 29 Nonetheless, no hemorrhagic episodes were reported among the patients in our study. Our results are in line with other studies which reported no significant impact of chelating agent on platelets count 14,30 but contradict other reports in which chelating agents caused thrombocytopenia.…”

Section: Discussionmentioning

confidence: 53%

Deferasirox in thalassemia: a comparative study between an innovator drug and its copy among a sample of Iraqi patients

Daher

Al-Momen

Jasim

2019

Therapeutic Advances in Drug Safety

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Background:The health care industry is witnessing an increasing trend in the use of generic medicines because of their presumed low cost compared with innovator medicines. The aim of this study was to determine and compare the performance of the copy drug Osveral®and its innovator drug deferasirox (Exjade®).Methods:A prospective observational study including 223 patients receiving the branded medicine Exjade®and 101 patients receiving the copy Osveral®was carried out. Data were assessed for a 1-year period and included clinical symptoms, serum ferritin (SF), serum creatinine (SC), and alanine aminotransferase (ALT). Data were analyzed with SPSS version 22 software (SPSS, Chicago, IL, USA).Results:The median age of the sample was 8 years. There was no significant difference in gender distribution between the two groups ( p = 0.625). Nausea was the most frequently reported adverse effect followed by diarrhea and abdominal pain in both groups. Patients receiving Exjade®had a higher relative reduction of SF at the end of the study compared with the Osveral®group (19.9% versus 9.93%, p = 0.028). SC was found to be significantly higher in the Osveral®group than in the Exjade®group throughout the study period. The mean platelet count was higher in the Exjade®group. ALT was significantly higher among patients receiving Osveral®over the last three months of the study.Conclusions:Exjade®showed a better ability to reduce SF, with less liver toxicity, and better hemostasis profile. No congenital anomalies associated with short-term use of both drugs during pregnancy were observed or reported.

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“…We also found that haematoma volume mediated the association between an elevated haemoglobin level and poor outcomes in ICH. The pathophysiologic mechanism for this might be the result of multiple factors, such as the hemin-induced platelet-dependent thrombosis dysfunction or the iron toxicity and its related inflammation and coagulopathy 8 21–23. Although iron overload is not directly associated with high haemoglobin levels, however, iron dysregulation could be found in haematological disease such as polycythemia vera.…”

Section: Discussionmentioning

confidence: 99%

High haemoglobin levels and mortality in males with intracerebral haemorrhage: a retrospective cohort study

Zhang

Shu

et al. 2022

BMJ Open

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ObjectivesTo examine the association between high haemoglobin levels and outcomes in intracerebral haemorrhage (ICH) in a multicentre cohort study.DesignProspective multicentre cohort study.Settings21 tertiary hospitals across mainland China.ParticipantsA total of 5318 consecutive in-hospital spontaneous ICH patients were recruited between January 2012 and June 2016.Primary and secondary outcome measuresHaemoglobin levels were measured on admission. Binary or ordinary logistic regression was used to evaluate the independent relationship of haemoglobin level with clinical outcomes at 3 months, measured as death or disability. Restricted cubic spline regression was fitted to examine the potential non-linear shape of the dose–response curve between the whole haemoglobin levels and 3-month poor outcomes.ResultsA total of 5031 patients with ICH were analysed (64.3% male; mean age (SD), 57.8 (15.2) years). We found that the highest haemoglobin quintile was associated with poor outcomes 3 months in males (adjusted OR (aOR) 1.65, 95% CI 1.21 to 2.25) but not in females, which was also observed in the pooled analysis of three subcohorts in male patients (average aOR 1.70, 95% CI 1.23 to 2.33). The spline regression suggested a non-linear association between haemoglobin levels and outcomes and a linear relationship was observed between an elevated haemoglobin level and 3-month disability/death in males (haemoglobin level per 10 g/L: aOR 1.24, 95% CI 1.10 to 1.40, p<0.001), which was mediated by larger haematoma volume (effect size: 0.115, 95% CI 0.012 to 0.231).ConclusionsThis study found a sex-specific association between an elevated haemoglobin level and poor 3-month outcomes, which might be mediated by larger haematoma volume.

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Iron Overload and Platelet Function Defects

Cited by 9 publications

References 21 publications

Predicting chemotherapy-induced thrombocytopenia in cancer patients with solid tumors or lymphoma

Predicting chemotherapy-induced thrombocytopenia in cancer patients with solid tumors or lymphoma

Deferasirox in thalassemia: a comparative study between an innovator drug and its copy among a sample of Iraqi patients

High haemoglobin levels and mortality in males with intracerebral haemorrhage: a retrospective cohort study

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