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

Autor: Liesbeth C. de Wreede, Jürgen Finke, Diderik Jan Eikema, Jorge Sierra, Yves Beguin, Gérard Socié, Achilles Anagnostopoulos, Zübeyde Nur Özkurt, Anja van Biezen, Tobias Gedde-Dahl, Guido Kobbe, Maija Itälä-Remes, Dietger Niederwieser, Linda Koster, Marie Robin, Theo de Witte, Pavel Jindra, Johan Maertens, Dimitris Ziagkos, Eline M. P. Cremers, Nicolaus Kröger, Dietrich W. Beelen, Arnon Nagler, Per Ljungman
Přispěvatelé: Clinicum, Department of Oncology, HUS Comprehensive Cancer Center, Hematology laboratory
Rok vydání: 2019
Předmět:
Male
Cancer Research
BLOOD
Cancer development and immune defence Radboud Institute for Molecular Life Sciences [Radboudumc 2]
Medizin
Graft vs Host Disease
PROGNOSTIC SCORING SYSTEM
0302 clinical medicine
Iron toxicity
Phlebotomy
allogeneic stem cell transplantation
hemic and lymphatic diseases
MDS
SERUM FERRITIN
biology
chelation therapy
transfusions
TRANSFERRIN-BOUND IRON
Incidence (epidemiology)
Incidence
Hematopoietic Stem Cell Transplantation
OVERLOAD
Hematology
Middle Aged
C-REACTIVE PROTEIN
3. Good health
surgical procedures
operative
Treatment Outcome
Oncology
030220 oncology & carcinogenesis
Toxicity
SURVIVAL
Female
Life Sciences & Biomedicine
Adult
medicine.medical_specialty
Iron Overload
3122 Cancers
ACUTE MYELOID-LEUKEMIA
03 medical and health sciences
Young Adult
Internal medicine
medicine
Humans
Transplantation
Homologous
Blood Transfusion
Chelation therapy
Aged
Proportional Hazards Models
Science & Technology
business.industry
INTENSITY
Myelodysplastic syndromes
C-reactive protein
medicine.disease
Chelation Therapy
Transplantation
Myelodysplastic Syndromes
biology.protein
phlebotomies
business
030215 immunology
Zdroj: Cremers, E M P, de Witte, T, de Wreede, L, Eikema, D-J, Koster, L, van Biezen, A, Finke, J R, Socié, G, Beelen, D, Maertens, J, Nagler, A, Kobbe, G, Ziagkos, D, Itälä-Remes, M, Gedde-Dahl, T, Sierra, J, Niederwieser, D, Ljungman, P, Beguin, Y, Ozkurt, Z N, Anagnostopoulos, A, Jindra, P, Robin, M & Kröger, N 2019, ' 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 * ', Leukemia and Lymphoma, vol. 60, no. 10, pp. 2404-2414 . https://doi.org/10.1080/10428194.2019.1594215
LEUKEMIA & LYMPHOMA
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname
Leukemia & Lymphoma, 60, 2404-2414
Leukemia & Lymphoma, 60, 10, pp. 2404-2414
Leukemia & Lymphoma, 60(10), 2404-2414
Leukemia and Lymphoma, 60(10), 2404-2414. Informa Healthcare
ISSN: 1029-2403
1042-8194
DOI: 10.1080/10428194.2019.1594215
Popis: 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. ispartof: LEUKEMIA & LYMPHOMA vol:60 issue:10 pages:2404-2414 ispartof: location:United States status: published
Databáze: OpenAIRE
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