Pretransplant elevated serum ferritin levels are associated with increased risk of invasive fungal pneumonia (IFP) in patients that underwent allogeneic hematopoietic stem cell transplantation (alloHSCT)
International Conference and Exhibition on Surgery, Anesthesia & Trichology
Serdar Sivgin, Suleyman Baldane, Leylagul Kaynar, Fatih Kurnaz, Cigdem Pala, Muzaffer Keklik, Hayati Demiraslan, Bulent Eser, Ali Unal1and Mustafa Cetin
Objectives and aim
: Invasive fungal pneumonia (IFP) has become increasingly common in patients that previously underwent
alloHSCT due to prolonged neutropenia, immunosuppressive therapies to prevent Graft-vs-host disease (GvHD) and widespread
use of broad-spectrum antibiotics. The aim of this study was to determine the role of hyperferritinemia in invasive fungal
pneumonia in patients that underwent alloHSCT.
Materials and Methods:
Medical records of 73 patients with pneumonia that underwent alloHSCT were studied retrospectively,
whereby a pre-transplantation serum ferritin level measured up to 100 days prior to transplantation of patients with invasive
fungal pneumonia (IFP) and non-fungal pneumonia (non-IFP) was compared.
Results: Patient records revealed 35 and 38 cases of IFP and non-IFP respectively. All 35 patients diagnosed with IFP also
showed signs of probable pneumonia. Isolated causative microorganisms were Candida spp in five (14.2 %) of the patients and
Aspergillosis in three (8.6 %). In risk evaluation for IFP, age, gender, HLA status, conditioning regimen, CD34+ count, donor
gender, GVHD presence, smoking history, and underlying disease were not significantly different among groups (p > 0.05).
However, performance status (Karnofsky) was significantly lower in patients with IFP (p < 0.05), compared to the control group.
The median ferritin levels were 1705 ng/ml (41 − 7198) in the IFP group and 845 ng/ml (18 − 7099) in non-IFP group and the
difference was found statistically significant (p = 0.001).
Conclusion: Elevated pretransplant serum ferritin level is associated with IFP in patients that underwent alloHSCT, in particular
when values exceed 1550 ng/ml.
Keywords: alloHSCT, invasive fungal pneumonia, ferritin, aspergillosis, survival.
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