Effect of pre-transplantation iron overload on the outcomes of allogeneic hematopoietic stem cell transplantation patients with non-hepatitis-related severe aplastic anemia
10.3760/cma.j.issn.0254-1785.2019.03.003
- VernacularTitle:非肝炎相关重型再生障碍性贫血受者移植前铁过载对allo-HSCT疗效的影响
- Author:
Yuanyuan SHI
1
;
Sudong ZHANG
;
Guixin ZHANG
;
Weihua ZHAI
;
Yi HE
;
Rongli ZHANG
;
Qiaoling MA
;
Aiming PANG
;
Donglin YANG
;
Jialin WEI
;
Yong HUANG
;
Erlie JIANG
;
Mingzhe HAN
;
Sizhou FENG
Author Information
1. 中国医学科学院 北京协和医学院血液学研究所血液病医院
- Keywords:
Allogeneic hematopoietic stem cell transplantation;
Ferritin;
Aplastic anemia;
Survival rate
- From:
Chinese Journal of Organ Transplantation
2019;40(3):133-137
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of iron overload on the outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) patiems with non-hepatitis related severe aplastic anemia (SAA).Methods The clinical data were retrospectively analyzed for 98 patients with non-hepatitis related SAA undergoing allo-HSCT from July 2012 to late July 2018 at a single center.Serum ferritin (SF) was measured within 2 momhs before HSCT.They were divided into iron overload (SF＞800.0 ng/ml,n =49) and control (SF＜800.0 ng/ml,n =49) groups according to SF level.Overall survival (OS),hematopoietic reconstitution and common complications after allo-HSCT were analyzed.Results The median pre-transplantation SF value was 798.7 (52.0-11060.01) ng/ml.Patients with pre-transplantation iron overload had a higher incidence of cytomegaloviremia (P =0.041),delayed recovery of neutrophil/platelet (P =0.001,P =0.005 respectively) and transfusion-dependence in donor-recipient blood group-matched patients (P =0.043) after allo-HSCT.The 3-year OS was (65.1 ± 7.1) ％ in iron overload group and (93.3 ± 3.7) ％ in control group (P =0.001).Multivariate analysis indicated that 3-year OS was independently correlated with pre-transplantation iron overload (P =0.022),blood group of donor & recipient (P =0.015),early bacteremia (P=0.003) and cytomegaloviremia (P =0.003).Conclusions Iron overload is common in patients with non-hepatitis-related SAA before transplantation.Pre-transplantation iron overload has a significant impact on OS,hematopoietic reconstitution and cytomegaloviremia after allo
