Non transferrin bound iron (NTBI) in acute leukemias throughout conventional intensive chemotherapy: Kinetics of its appearance and potential predictive role in infectious complications

Belotti, Angelo; Duca, Lorena; Borin, Lorenza; Réalini, S; Renso, Rossella; Parma, Matteo; Pioltelli, Pietro; Pogliani, Enrico Maria; Cappellini, Maria Domenica

doi:10.1016/j.leukres.2014.11.003

Cited by 20 publications

(12 citation statements)

References 13 publications

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“…Similarly, following oral iron supplementation, the increased serum iron enhanced proliferation in vitro of several bacterial pathogens, including E. coli ( 31 ). Circulating NTBI is also associated with increased risks of infectious complications following myelosuppression for acute leukemia, where patients with plasma NTBI levels >2 µM, like those observed in this study after transfusing RBCs stored for >20 days, had a higher risk of Gram-negative sepsis (P = 0.0004) ( 32 ). This raises the possibility that the NTBI produced following some RBC transfusions may be responsible for the purported association between RBC transfusion and necrotizing enterocolitis ( 3 , 4 ).…”

Section: Discussionmentioning

confidence: 51%

Effect of red blood cell storage time on markers of hemolysis and inflammation in transfused very low birth weight infants

et al. 2017

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Background Prolonged storage of transfused red blood cells (RBCs) is associated with hemolysis in healthy adults and inflammation in animal models. We aimed to determine whether storage duration affects markers of hemolysis (e.g., serum bilirubin, iron, and non-transferrin-bound iron (NTBI)) and inflammation (e.g., interleukin (IL)-8 and monocyte chemoattractant protein (MCP)-1) in transfused very low birth weight (VLBW) infants. Methods Blood samples from 23 independent transfusion events were collected by heel stick before and 2–6h after transfusion. Results Serum iron, total bilirubin, NTBI, and MCP-1 levels were significantly increased after transfusion of RBCs (P<0.05 for each comparison). The storage age of transfused RBCs positively correlated with increases in NTBI following transfusion (P<0.001; R2 = 0.44). No associations between storage duration and changes in the other analytes were observed. Conclusions Transfusion of RBCs into VLBW infants is associated with increased markers of hemolysis and the inflammatory chemokine MCP-1. RBC storage duration only correlated with increases in NTBI levels following transfusion. NTBI was only observed in healthy adults following 35 days of storage; however, this study suggests that VLBW infants are potentially more susceptible to producing this pathological form of iron, with increased levels observed after transfusion of only 20-day old RBCs.

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Section: Discussionmentioning

confidence: 51%

Effect of red blood cell storage time on markers of hemolysis and inflammation in transfused very low birth weight infants

et al. 2017

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“…Clinically, during conventional chemotherapy treatment, free iron levels > 2 μM were significantly correlated with a higher risk of sepsis caused by gram-negative bacilli for patients with acute leukaemia 13 . Furthermore, as described in previous studies 6 , 14 , patients with haemochromatosis, a hereditary disease characterized by an iron overload, were highly susceptible to infections by various pathogens, including Escherichia coli , V ibrio vulnificus , Vibrio cholera , Klebsiella species, Listeria monocytogenes , and Shigella species.…”

Section: Discussionmentioning

confidence: 98%

High Serum Iron level is Associated with Increased Mortality in Patients with Sepsis

Lan

Pan

Wang

et al. 2018

Sci Rep

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Iron is an essential nutrient for bacterial survival and thus higher iron levels may precipitate bacterial infections. We investigated the association between the serum iron level and prognosis in patients with sepsis by using the single-centre Medical Information Mart for Intensive Care III (MIMIC-III) database. Sepsis patients with iron parameters measured on ICU admission were included and stratified according to quartiles of serum iron levels. A total of 1,891 patients diagnosed with sepsis according to the Sepsis-3 criteria were included in this study, 324 of whom were septic shock. After adjusting for confounding variables, higher iron quartile was associated with an increase in 90-day mortality in the Cox regression analysis. Moreover, a stepwise increase in the risk of 90-day mortality was observed as the quartiles of serum iron levels increased in the patients with sepsis. In conclusion, higher serum iron levels were independently associated with increased 90-day mortality in this large cohort of patients with sepsis.

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“…Furthermore, in a retrospective analysis of patients receiving red cells stored for either 21 days or less or 35 days or more, there was a higher prevalence of infection in those receiving the older units (P = 0.007) (13). In other clinical settings, circulating nontransferrin-bound iron is also associated with increased risks of infectious complications; for example, following myelosuppression for acute leukemia, patients with plasma nontransferrin-bound iron levels greater than 2 μM had a higher risk of Gram-negative sepsis (P = 0.0004) (30). Finally, by participating in Fenton chemistry, nontransferrin-bound iron causes oxidative damage and cytotoxicity and enhances endothelial expression of adhesion molecules, thereby increasing thrombotic risk (19,21,31,32).…”

Section: Discussionmentioning

confidence: 99%

Prolonged red cell storage before transfusion increases extravascular hemolysis

Rapido¹,

Brittenham²,

Bandyopadhyay³

et al. 2016

Journal of Clinical Investigation

164

190

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Non transferrin bound iron (NTBI) in acute leukemias throughout conventional intensive chemotherapy: Kinetics of its appearance and potential predictive role in infectious complications

Cited by 20 publications

References 13 publications

Effect of red blood cell storage time on markers of hemolysis and inflammation in transfused very low birth weight infants

Effect of red blood cell storage time on markers of hemolysis and inflammation in transfused very low birth weight infants

High Serum Iron level is Associated with Increased Mortality in Patients with Sepsis

Prolonged red cell storage before transfusion increases extravascular hemolysis

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