Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
Leuk Lymphoma. 2012 Mar;53(3):456-61. doi: 10.3109/10428194.2011.619607. Epub 2011 Oct 24.
A multicenter retrospective analysis of the influence of pretransplant serum ferritin (SF) was performed in 261 adult recipients of allogeneic hematopoietic stem cell transplant (allo-HSCT), including 159 patients with acute myeloid leukemia (AML), 66 with acute lymphoid leukemia (ALL) and 36 with myelodysplastic syndrome (MDS). Patients were divided into subgroups according to the pretransplant SF level [< 1000 ng/mL (low) vs. ≥ 1000 ng/mL (high)] and disease status at transplant. A high SF level was significantly associated with high disease risk (p = 0.041), but pretransplant SF and disease risk were independent significant prognostic factors for overall survival (OS), disease-free survival (DFS) and non-relapse mortality rate (NRM) on multivariate analysis. The high-SF group showed a worse outcome than the low-SF group among both standard-risk patients (OS: 54% vs. 64%, p = 0.043; DFS: 46% vs. 57%, p = 0.031) and high-risk patients (OS: 16% vs. 35%, p = 0.001; DFS: 15% vs. 34%, p = 0.001). In conclusion, a high SF at transplant adversely influences the outcome of allo-HSCT regardless of disease risk in patients with acute leukemia and MDS.
对 261 例接受异基因造血干细胞移植（allo-HSCT）的成人患者的移植前血清铁蛋白（SF）的影响进行了多中心回顾性分析，包括 159 例急性髓系白血病（AML）患者、66 例急性淋巴细胞白血病（ALL）患者和 36 例骨髓增生异常综合征（MDS）患者。根据移植前 SF 水平[<1000ng/mL（低）与≥1000ng/mL（高）]和移植时疾病状态，将患者分为亚组。高 SF 水平与高疾病风险显著相关（p=0.041），但 SF 和疾病风险是总生存（OS）、无病生存（DFS）和非复发死亡率（NRM）的独立预后因素。在多因素分析中，SF 高组的标准风险患者（OS：54%vs.64%，p=0.043；DFS：46%vs.57%，p=0.031）和高风险患者（OS：16%vs.35%，p=0.001；DFS：15%vs.34%，p=0.001）的结果均比 SF 低组差。总之，无论急性白血病和 MDS 患者的疾病风险如何，移植时高 SF 都会对 allo-HSCT 的结果产生不利影响。
