A prospective non-interventional study on the impact of transfusion burden and related iron toxicity on outcome in myelodysplastic syndromes undergoing allogeneic hematopoietic cell transplantation
Cremers, Eline M.P. (VU University Medical Centre)
de Witte, Theo (Radboud University Medical Centre)
de Wreede, Liesbeth C. (Leiden University Medical Center)
Eikema, Diderik-Jan (EBMT Statistical Unit Data Office Leiden)
Koster, Linda (EBMT Data Office Leiden)
van Biezen, Anja (EBMT Data Office Leiden)
Finke, Jürgen (University of Freiburg)
Socié, Gerard (Hospital St. Louis)
Beelen, Dietrich (University Hospital)
Maertens, Johan (University Hospitals Gasthuisberg (Leuven, Bélgica))
Nagler, Arnon (Chaim Sheba Medical Center (Israel))
Kobbe, Guido (Heinrich Heine Universitaet)
Ziagkos, Dimitris (EBMT Statistical Unit Data Office Leiden)
Itälä-Remes, Maija (HUCH Comprehensive Cancer Center)
Gedde-Dahl, Tobias (Oslo University Hospital (Oslo, Noruega))
Sierra, Jorge (Institut d'Investigació Biomèdica Sant Pau)
Niederwieser, Dietger (University Hospital Leipzig)
Ljungman, Per (Karolinska University Hospital and Karolinska Institutet (Suecia))
Beguin, Yves (University of Liège)
Ozkurt, Zubeyde Nur (Gazi University)
Anagnostopoulos, Achilles (George Papanicolaou General Hospital (Tessalònica, Grècia))
Jindra, Pavel (Charles University Hospital)
Robin, Marie (Hospital St. Louis)
Kröger, Nicolaus (University Hospital Eppendorf)
Universitat Autònoma de Barcelona

Fecha:	2019
Resumen:	Most myelodysplastic syndromes (MDS)-patients receive multiple red blood cell transfusions (RBCT). Transfusions may cause iron-related toxicity and mortality, influencing outcome after allogeneic HSCT. This prospective non-interventional study evaluated 222 MDS and CMML patients undergoing HSCT. Overall survival (OS), relapse-free survival (RFS), non-relapse mortality (NRM), and relapse incidence (RI) at 36 months were 52%, 44%, 25%, and 31%, respectively. Age, percentage of marrow blasts and severe comorbidities impacted OS. RFS was significantly associated with RBCT burden prior to HSCT (HR: 1. 7; p =. 02). High ferritin levels had a significant negative impact on OS and RI, but no impact on NRM. Administration of iron chelation therapy prior to HSCT did not influence the outcome, but early iron reduction after HSCT (started before 6 months) improved RFS significantly after transplantation (56% in the control group vs. 90% in the treated group, respectively; p =. 04). This study illustrates the impact of RBCT and related parameters on HSCT-outcome. Patients with an expected prolonged survival after transplantation may benefit from early iron reduction therapy after transplantation.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	Leukemia and Lymphoma, Vol. 60 Núm. 10 (2019) , p. 2404-2414, ISSN 1029-2403

DOI: 10.1080/10428194.2019.1594215
PMID: 30997844

13 p, 1.7 MB

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