Department of Hematology, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, Japan.
Int J Hematol. 2013 Jan;97(1):125-34. doi: 10.1007/s12185-012-1252-1. Epub 2012 Dec 23.
Iron overload is a common complication in allogeneic hematopoietic cell transplantation (HCT). We studied the prevalence of iron overload using serum ferritin from 122 allogeneic HCT survivors who had survived a median of 1259 (range 134-4261) days. We also quantified iron overload by determining non-transferrin-bound iron (NTBI), which reflects iron overload more directly than ferritin, and compared the results with those of the ferritin assay. Fifty-two patients (43 %) showed hyperferritinemia (HF) (serum ferritin >1000 ng/mL), and there was a moderate correlation between serum ferritin and the number of transfused red blood cell units (ρ = 0.71). In multivariate analyses, HF was a significant risk factor for liver dysfunction (P = 0.0001) and diabetes (P = 0.02), and was related to a lesser extent with performance status (P = 0.08). There was a significant correlation between serum ferritin and NTBI (ρ = 0.59); however, the association of NTBI with these outcomes was weaker than that of serum ferritin. In conclusion, serum ferritin is a good surrogate marker of iron overload after allogeneic HCT, and reflects organ damage more accurately than NTBI.
铁过载是异基因造血细胞移植（HCT）后的常见并发症。我们研究了 122 名异基因 HCT 幸存者的血清铁蛋白，这些幸存者的中位存活时间为 1259 天（范围 134-4261 天），以确定铁过载的患病率。我们还通过测定非转铁蛋白结合铁（NTBI）来定量铁过载，NTBI 比铁蛋白更直接地反映铁过载，并将结果与铁蛋白检测结果进行比较。52 名患者（43%）表现为高铁蛋白血症（HF）（血清铁蛋白>1000ng/mL），血清铁蛋白与输注的红细胞单位数量之间存在中度相关性（ρ=0.71）。在多变量分析中，HF 是肝功能障碍（P=0.0001）和糖尿病（P=0.02）的显著危险因素，与表现状态的相关性较小（P=0.08）。血清铁蛋白与 NTBI 之间存在显著相关性（ρ=0.59）；然而，与这些结果的相关性弱于血清铁蛋白。总之，血清铁蛋白是异基因 HCT 后铁过载的良好替代标志物，比 NTBI 更能准确反映器官损伤。
