A prognostic score with pretransplant serum ferritin and disease status predicts outcome following reduced-intensity SCT

Abstract

Abbreviations: MDS ¼ myelodysplastic syndrome; NR ¼ non-remission; RA ¼ refractory anemia; RAEB ¼ refractory anemia with excess blasts.

Clinical significance of pretransplant serum ferritin on the outcome of allogeneic hematopoietic SCT: a prospective cohort study by the Kanto Study Group for Cell Therapy

“…We and other groups have previously demonstrated that high serum ferritin levels before HSCT may reduce OS and EFS after HSCT. [1][2][3][4][5][6][7][8][21][22][23][24] To the best of our knowledge, the present study is the first to confirm these findings using a large prospective cohort.…”

“…Recent studies have demonstrated that pretransplant iron overload, defined as elevated serum ferritin levels, is associated with worse OS, disease-free survival and non-relapse mortality (NRM) and with an increased risk of infection in patients undergoing allogeneic HSCT. [1][2][3][4][5][6][7][8][9] Liver dysfunction caused by iron overload 10 and neutrophil dysfunction with an increase in non-transferrin-bound iron levels 11,12 may have a negative impact on HSCT outcomes. However, most previous studies involved retrospective analyses of patients with heterogeneous diseases.…”

Prognostic impact of pretransplantation hyperferritinemia in adults undergoing allogeneic hematopoietic SCT: a meta-analysis

“…To further stratify patients in clinical studies, a scoring system that consists of SF and disease status at transplantation might be valuable to predict the outcomes. 6,7 From this study, we cannot deduce that the adverse prognostic impact of pretransplantation HF is associated with iron overload. To provide definitive answers regarding the role of iron overload in HSCT, we should in future, as Dr Armand suggested, perform studies that incorporate direct measurements of parenchymal and labile iron.…”

Iron Overload and Hematopoetic Stem Cell Transplantation

“…Several recent reports demonstrated that IO is an adverse prognostic factor for patients undergoing allo-HSCT [1,17,22,36,59,[62][63][64][65][66]. In a retrospective cohort of 114 AML and MDS patients, the OS rate at 5 years was found to be significantly better in patients with ferritin levels < 1000 ng/ml [1].…”