Association of Serum Ferritin Levels Before Start of Conditioning With Mortality After alloSCT - A Prospective, Non-interventional Study of the EBMT Transplant Complications Working Party
Penack, Olaf (Charité - Universitätsmedizin Berlin)
Peczynski, Christophe (EBMT Statistical Unit)
van der Werf, Steffie (EBMT Data Office)
Finke, Jürgen (University of Freiburg)
Ganser, Arnold (Hannover Medical School)
Schoemans, Helene (University Hospitals Leuven (Bèlgica))
Pavlu, Jiri (Imperial College London)
Niittyvuopio, Riitta (HUCH Comprehensive Cancer Center)
Schroyens, W.ilfried (University Hospital Antwerp (Bèlgica))
Kaynar, Leylagül (Erciyes University)
Blau, Igor W. (Department of Hematology. Oncology. and Tumor Immunology)
van der Velden, Walter J.F.M. (Radboud University)
Malouf Sierra, Jorge 1971- (Institut d'Investigació Biomèdica Sant Pau)
Cortelezzi, Agostini (University of Milan)
Wulf, Gerald (Universitätsklinikum Göttingen)
Turlure, Pascal (CHRU Limoges)
Rovira Argelagués, Montserrat (Hospital Clínic i Provincial de Barcelona)
Ozkurt, Zubeydenur (Gazi University)
Pascual-Cascon, Maria J. (Hospital Regional Universitario de Málaga)
Moreira, Maria C. (Instituto National do Cancer)
Clausen, Johannes (Ordensklinikum Linz Elisabethinen)
Greinix, Hildegard (Medical University of Graz)
Duarte, Rafael F. (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Basak, Grzegorz (Medical University of Warsaw)
Universitat Autònoma de Barcelona

Data:	2020
Resum:	Elevated serum ferritin levels occur due to iron overload or during inflammation and macrophage activation. A correlation of high serum ferritin levels with increased mortality after alloSCT has been suggested by several retrospective analyses as well as by two smaller prospective studies. This prospective multicentric study aimed to study the association of ferritin serum levels before start of conditioning with alloSCT outcome. Patients with acute leukemia, lymphoma or MDS receiving a matched sibling alloSCT for the first time were considered for inclusion, regardless of conditioning. A comparison of outcomes between patients with high and low ferritin level was performed using univariate analysis and multivariate analysis using cause-specific Cox model. Twenty centers reported data on 298 alloSCT recipients. The ferritin cut off point was determined at 1500 μg/l (median of measured ferritin levels). In alloSCT recipients with ferritin levels above cut off measured before the start of conditioning, overall survival (HR = 2. 5, CI = 1. 5-4. 1, p = 0. 0005) and progression-free survival (HR = 2. 4, CI = 1. 6-3. 8, p < 0. 0001) were inferior. Excess mortality in the high ferritin group was due to both higher relapse incidence (HR = 2. 2, CI = 1. 2-3. 8, p = 0. 007) and increased non-relapse mortality (NRM) (HR = 3. 1, CI = 1. 5-6. 4, p = 0. 002). NRM was driven by significantly higher infection-related mortality in the high ferritin group (HR = 3. 9, CI = 1. 6-9. 7, p = 0. 003). Acute and chronic GVHD incidence or severity were not associated to serum ferritin levels. We conclude that ferritin levels can serve as routine laboratory biomarker for mortality risk assessment before alloSCT.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Biomarker ; Ferritin ; Immunology ; Iron metabolism ; Stem cell ; Transplantation
Publicat a:	Frontiers in immunology, Vol. 11 (15 2020) , p. 586, ISSN 1664-3224

DOI: 10.3389/fimmu.2020.00586
PMID: 32351502

8 p, 3.0 MB

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