Iron Overload: Predictor of Adverse Outcome in Hematopoietic Stem Cell Transplantation

Sucak, Gülsan Türköz; Yeğin, Zeynep Arzu; Özkurt, Zübeyde Nur; Akı, Şahika Zeynep; Yağcı, Münci

doi:10.1016/j.transproceed.2009.11.049

Cited by 41 publications

(49 citation statements)

References 40 publications

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“…The cumulative effects of multiple predisposing factors, such as underlying malignancy, transfusion burden, hepcidin dysregulation, mucositis, GVHD, and the inflammatory milieu of the underlying hematologic disease and infections, contribute to the multifactorial etiology of elevated pretransplant ferritin levels and IO. Although IO is a fact in the pretransplant patients as previously described [15][16][17][18], the overestimated ferritin values or the multifactorial etiology of IO might have masked the relationship between H63D mutation and iron parameters in our study population. HFE heterozygous or even homozygous mutations for H63D were found not to alter serum ferritin levels even in a healthy population in a previous study from Spain [28].…”

Section: Discussionmentioning

confidence: 63%

“…Consequently, alternative therapeutic options might be considered for patients who are not expected to benefit from HSCT [23,24]. Iron overload is indicated to be a significant cause of transplant-related morbidity and mortality [15][16][17][18]. Genetic background of IO has not been evaluated thoroughly in HSCT recipients; hence, the impact of genetic basis of IO on transplant morbidity remains to be elucidated.…”

Section: Discussionmentioning

confidence: 99%

“…Prolonged dyserythropoiesis, hemolysis, increased intestinal iron absorption, hepcidin dysregulation, and transfusion burden are the major causes of IO in HSCT recipients. On the other hand, HFE genotype might as well have a contributing role in the iron-overloaded state of HSCT recipients [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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The prognostic role of hemochromatosis H63D allele in allogeneic hematopoietic stem cell transplantation

et al. 2012

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Iron overload is considered as a significant cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients. The presence of hemochromatosis gene (HFE) mutations might exacerbate iron toxicity in the post-transplant setting. This prospective study was planned to evaluate the genetic spectrum of HFE mutations in Turkish patients undergoing HSCT and the impact of HFE genotype on transplant morbidity and mortality. HFE genotypes of 102 patients [median age, 27.5 years (16-64 years); male/female, 73:29], who underwent allogeneic HSCT, were analyzed. Twenty-two patients were heterozygous and 1 patient was homozygous for the H63D mutation, while the C282Y mutation was observed in none of our patients. The frequency of invasive fungal infections (IFI) was significantly higher in H63D-mutated patients (p=0.004). H63D mutation was identified as an independent risk factor for the development of IFI (p=0.006, OR=0.554, SE=0.208), without an impact on overall survival and transplant-related mortality. The multifactorial iron-overloaded state in HSCT recipients might affect the phenotypic expression of HFE mutations and alter the severity of clinical presentation. The impact of HFE genotype on iron parameters and transplant-related morbidity and mortality should be validated with further studies.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

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The prognostic role of hemochromatosis H63D allele in allogeneic hematopoietic stem cell transplantation

et al. 2012

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“…A significant effect of pre-HSCT ferritin concentration on OS and transplant-related mortality (TRM) was observed. 27 In a retrospective study by Lim et al, the impact of pre-HSCT ferritin on transplant outcome was evaluated in 99 MDS patients receiving reduced intensity conditioning HSCT. Elevated serum ferritin and pre-HSCT >5% marrow blasts were independent predictors of an inferior OS.…”

Section: Figurementioning

confidence: 99%

Ferritin: Is it a Predictor of Prognosis in Myelodysplastic Syndrome?

Yeğin¹,

Hızal²,

Sadioğlu³

et al. 2017

World Clin J Med Sci

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“…There is a growing body of evidence showing an association between elevated serum ferritin (s-ferritin) levels prior to hematopoietic cell transplantation (HCT) and an adverse outcome in patients with hematological disease [1,2,3,4,5,6,7,8,9,10,11,12,13]. In most of the reports, the s-ferritin level before HCT was used as a surrogate marker of the iron burden.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value and Clinical Implication of Serum Ferritin Levels following Allogeneic Hematopoietic Cell Transplantation

Nakamae¹,

Nakamae²,

Koh³

et al. 2014

Acta Haematol

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Little research has been done on changes in serum ferritin (s-ferritin) levels and clinical implications following allogeneic hematopoietic cell transplantation (HCT). We retrospectively evaluated the correlation of s-ferritin levels after HCT with survival in 203 patients. The s-ferritin level was significantly elevated, with 75% of the patients showing peak levels 90 days after HCT. The level was >10,000 ng/ml in a total of 43% of the patients, a finding that was associated with febrile neutropenia or infection. The s-ferritin level at day 30 and at 1 year after HCT was significantly associated with prognosis. However, this statistically significant relationship was lost after adjusting for acute-phase reactants. We conclude that hyperferritinemia is very common and the degree of influence of a red blood cell transfusion will vary depending on the phase after HCT. A prospective study is needed to determine if iron load in and of itself contributes to a worse prognosis after HCT. © 2014 S. Karger AG, Basel

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Iron Overload: Predictor of Adverse Outcome in Hematopoietic Stem Cell Transplantation

Cited by 41 publications

References 40 publications

The prognostic role of hemochromatosis H63D allele in allogeneic hematopoietic stem cell transplantation

The prognostic role of hemochromatosis H63D allele in allogeneic hematopoietic stem cell transplantation

Ferritin: Is it a Predictor of Prognosis in Myelodysplastic Syndrome?

Prognostic Value and Clinical Implication of Serum Ferritin Levels following Allogeneic Hematopoietic Cell Transplantation

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