Elevated pretransplant serum ferritin is associated with inferior survival following nonmyeloablative allogeneic transplantation

Iron overload in hematopoietic cell transplantation

“…40,41,46,47 There are also emerging data from retrospective studies that pretransplant hyperferritinemia can significantly increase the risk of early nonrelapse mortality after allogeneic and autologous HCT. 36,[50][51][52][53][54] Free iron can lead to a pro-oxidant state by generating free radicals which could subsequently cause tissue injury and increase the risk of transplant related complications. However, ferritin does not reliably predict body iron stores and the contribution of iron overload to early morbidity and mortality needs to be confirmed in prospective studies.…”

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

“…[1][2][3] Recent studies have demonstrated the prognostic impact of elevated serum ferritin on survival and complications following reduced-intensity SCT (RIST). [3][4][5][6] We previously reported a simple scoring system that consisted of serum ferritin and disease status at transplantation for predicting outcome in patients with AML and myelodysplastic syndrome (MDS). 7 In this report, we studied the applicability of the prognostic score to patients who received RIST in our center.…”

Iron overload in hematologic malignancies and outcome of allogeneic hematopoietic stem cell transplantation

“…Of note, this is in contrast to the results of a smaller singleinstitution retrospective analysis of 64 patients which suggested that elevated pre-transplantation serum ferritin had an independent, negative impact on survival in reduced intensity conditioned HSCT. 26 An attempt made to determine the impact of increasing iron overload in terms of quantity of RBC transfusions, showed that overall survival and transplant-related mortality were significantly worse in patients undergoing myeloablative HSCT who had received more than 20 packed RBC units pre-transplantation (and further impaired in those who had received more than 40 packed RBC units), while outcomes for patients receiving 20 or fewer packed RBC units were comparable to those of non-transfusion-dependent patients. Additionally, increasing pre-transplant serum ferritin levels were also associated with worse overall survival and transplantrelated mortality in the RBC transfusion-dependent patients.…”