Author(s): Ak SZ, Paaolu H, Yein ZA, Suyan E, Demirta CY,
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Abstract OBJECTIVE: Recent reports show the adverse impact of pre-transplantation iron overload on the outcome of haematopoietic stem cell transplantation (HSCT). We studied the pre-transplantation serum iron (SI) parameters including prohepcidin levels - a regulatory peptide of systemic iron homeostasis - and their role in early post-transplantation toxicities in allogeneic HSCT recipients. PATIENTS AND METHODS: One hundred consecutive patients [36 women and 64 men; median age 27·5 years (range 16-63 years)] who underwent allogeneic HSCT between September 2003 and October 2007 at Gazi University were included in the study. RESULTS: Pre-transplantation serum prohepcidin levels did not show correlation with SI parameters and interleukin-6 levels (P>0·05). Prohepcidin levels were inversely correlated with the National Cancer Institute grade of mucositis (P=0·060), neutropenic fever (P<0·001), and the number of days with febrile neutropenia (P=0·003). SI levels were correlated with the severity of hepatotoxicity (P=0·015) while pre-transplantation transferrin saturation levels were positively correlated with the severity of hepatotoxicity (P=0·055), pulmonary toxicity (P=0·032), and sinusoidal obstruction syndrome (P=0·049). Pre-transplantation serum ferritin levels were positively correlated with the development of sinusoidal obstruction syndrome (P=0·010) and inversely correlated with the day of neutrophil engraftment (P=0·012). Overall survival was 41·26\% with a median follow-up time of 13 months (range 0·0-60 months). Pre-transplantation serum prohepcidin levels and iron overload were not associated with survival in Cox regression analysis. CONCLUSION: Our results suggest that pre-transplantation iron parameters and prohepcidin levels might predict some of the early post-transplantation toxicities, however, without an impact on overall survival.
This article was published in Hematology
and referenced in Biochemistry & Physiology: Open Access