Effect of pretransplant iron overload on clinical efficacy of allogeneic hematopoietic stem cell transplantation on severe aplastic anemia
10.3969/j.issn.1674-7445.2020.02.008
- VernacularTitle:移植前铁过载对重型再生障碍性贫血异基因造血干细胞移植疗效的影响
- Author:
Tianzhong PAN
1
;
Baolin TANG
;
Xiaoyu ZHU
;
Huilan LIU
;
Kaidi SONG
;
Xiang WAN
;
Wen YAO
;
Guangyu SUN
;
Jian WANG
;
Zimin SUN
Author Information
1. Anhui Medical University, Heifei 230000, China
- Publication Type:Research Article
- Keywords:
Iron overload;
Severe aplastic anemia;
Allogeneic hematopoietic stem cell transplantation;
Transplantation related mortality;
Overall survival;
Umbilical cord blood stem cell transplantation;
Sibling allogeneic hematopoietic stem cell transplantation
- From:
Organ Transplantation
2020;11(2):234-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of pretransplant iron overload on the clinical efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with severe aplastic anemia (SAA). Methods Clinical data of 80 SAA recipients who underwent allo-HSCT for the first time were retrospectively analyzed. According to the incidence of iron overload, all recipients were divided into the iron overload group (n=20) and non-iron overload group (n=60). The engraftment rate, incidence of postoperative complications and clinical prognosis of the recipients afterallo-HSCT were statistically compared between two groups. The influencing factors of 2-year overall survival (OS) and 180 d transplantation related mortality (TRM) were analyzed by Cox proportional hazards regression model. Results The engraftment rate of neutrophils in the non-iron overload group was 98% (59/60), significantly higher than 75% (15/20) in the iron overload group (P < 0.05). The engraftment rate of platelet in the non-iron overload group was 90% (54/60), significantly higher than 65% (13/20) in the iron overload group (P < 0.05). The incidence rate of bloodstream infection in the non-iron overload group was 23% (14/60), remarkably lower than 40% (8/20) in the iron overload group (P < 0.05). The 180 d TRM of the recipients in the non-iron overload group was 17%, significantly lower than 45% in the iron overload group (P < 0.05). The 1- and 2-year OS of the recipients in the non-iron overload group were 82% and 80%, significantly higher than 50% and 44% in the iron overload group (both P < 0.05). Iron overload or not was an independent risk factor of the OS and TRM of the recipients (both P < 0.05). Conclusions Iron overload can affect the OS and TRM of SAA patients after allo-HSCT.
