Iron Overload in Patients Receiving Allogeneic Hematopoietic Stem Cell Transplantation

Abstract

Iron overload has been associated to a variety of post-transplant complications, including infections, sinusoidal obstructive syndrome and it is conceivable that increased hepatic iron may mimic the clinical picture of GVHD or even may contribute to the worsening of hepatic GVHD. Objectives and Methods: aim of present review was to summarize the current knowledge about diagnosis and treatment strategies of iron overload following HSCT. Results: serum ferritin may be considered as surrogate marker of iron overload and is widely used as an indicator of body iron status; however other noninvasive diagnostic methods, namely SQUID and MRI, may provide more precise information on iron burden in specific organs, such as liver and heart. Since there are not physiological tools to remove efficiently the excess of iron, it is of particular importance to consider iron depleting therapy. Phlebotomy should be considered as the first line treatment of iron overload, while iron chelators, such as deferasirox, may represent an alternative option for patients with an inadequate hematological recovery. Discussion: additional prospective studies are mandatory to investigate the relationship between iron overload and the outcome of patients receiving an allogeneic stem cell transplantation.