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

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Cremers , E M P , de Witte , T , de Wreede , L , Eikema , D-J , Koster , L , van Biezen , A , Finke , J , Socie , 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 & lymphoma , vol. 60 , no. 10 , pp. 2404-2414 . https://doi.org/10.1080/10428194.2019.1594215

Title: 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
Author: Cremers, Eline M. P.; de Witte, Theo; de Wreede, Liesbeth; Eikema, Diderik-Jan; Koster, Linda; van Biezen, Anja; Finke, Jurgen; Socie, Gerard; Beelen, Dietrich; Maertens, Johan; Nagler, Arnon; Kobbe, Guido; Ziagkos, Dimitris; Itälä-Remes, Maija; Gedde-Dahl, Tobias; Sierra, Jorge; Niederwieser, Dietger; Ljungman, Per; Beguin, Yves; Ozkurt, Zubeyde Nur; Anagnostopoulos, Achilles; Jindra, Pavel; Robin, Marie; Kröger, Nicolaus
Contributor: University of Helsinki, Clinicum
Date: 2019-08-24
Language: eng
Number of pages: 11
Belongs to series: Leukemia & lymphoma
ISSN: 1042-8194
URI: http://hdl.handle.net/10138/308443
Abstract: 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.
Subject: MDS
allogeneic stem cell transplantation
transfusions
phlebotomies
chelation therapy
PROGNOSTIC SCORING SYSTEM
ACUTE MYELOID-LEUKEMIA
TRANSFERRIN-BOUND IRON
C-REACTIVE PROTEIN
SERUM FERRITIN
OVERLOAD
BLOOD
INTENSITY
SURVIVAL
3122 Cancers
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