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Does iron overload really matter in stem cell transplantation?
Author(s) -
Armand Philippe,
Sainvil MarieMichele,
Kim Haesook T.,
Rhodes Joanna,
Cutler Corey,
Ho Vincent T.,
Koreth John,
Alyea Edwin P.,
Neufeld Ellis J.,
Kwong Raymond Y.,
Soiffer Robert J.,
Antin Joseph H.
Publication year - 2012
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.23188
Subject(s) - medicine , hematopoietic stem cell transplantation , ferritin , gastroenterology , myelodysplastic syndromes , transplantation , retrospective cohort study , bone marrow
A growing body of evidence suggests that iron overload is associated with inferior outcomes after myeloablative allogeneic hematopoietic stem cell transplantation (HSCT). However, all of those studies used surrogate markers of iron overload, especially serum ferritin, and most had a retrospective design. We conducted a prospective observational study in patients with myelodysplastic syndrome or acute leukemia undergoing myeloablative HSCT. Forty‐five patients who were followed for over 1 year, with serial measurements of serum iron parameters, as well as liver and cardiac magnetic resonance imaging. There was no significant increase in ferritin, liver or cardiac iron content in the 12 months following HSCT. Although serum ferritin still appeared to have prognostic significance, as previously reported, pre‐HSCT iron overload (as reflected in liver iron content) was not associated with increased mortality, relapse, or graft‐versus‐host disease. These results raise the possibility that the adverse prognostic impact of pre‐HSCT hyperferritinemia may be related to factors independent of iron overload. Am. J. Hematol. 87:569–572, 2012. © 2012 Wiley Periodicals, Inc.