Association of Serum Ferritin Levels Before Start of Conditioning With Mortality After alloSCT - A Prospective, Non-interventional Study of the EBMT Transplant Complications Working Party

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Penack , O , Peczynski , C , van der Werf , S , Finke , J , Ganser , A , Schoemans , H , Pavlu , J , Niittyvuopio , R , Schroyens , W , Kaynar , L , Blau , I W , van der Velden , W J F M , Sierra , J , Cortelezzi , A , Wulf , G , Turlure , P , Rovira , M , Ozkurt , Z , Pascual-Cascon , M J , Moreira , M C , Clausen , J , Greinix , H , Duarte , R F & Basak , G W 2020 , ' Association of Serum Ferritin Levels Before Start of Conditioning With Mortality After alloSCT - A Prospective, Non-interventional Study of the EBMT Transplant Complications Working Party ' , Frontiers in Immunology , vol. 11 , 586 . https://doi.org/10.3389/fimmu.2020.00586

Title: Association of Serum Ferritin Levels Before Start of Conditioning With Mortality After alloSCT - A Prospective, Non-interventional Study of the EBMT Transplant Complications Working Party
Author: Penack, Olaf; Peczynski, Christophe; van der Werf, Steffie; Finke, Juergen; Ganser, Arnold; Schoemans, Helene; Pavlu, Jiri; Niittyvuopio, Riitta; Schroyens, Wilfried; Kaynar, Leylagul; Blau, Igor W.; van der Velden, Walter J. F. M.; Sierra, Jorge; Cortelezzi, Agostino; Wulf, Gerald; Turlure, Pascal; Rovira, Montserrat; Ozkurt, Zubeydenur; Pascual-Cascon, Maria J.; Moreira, Maria C.; Clausen, Johannes; Greinix, Hildegard; Duarte, Rafael F.; Basak, Grzegorz W.
Other contributor: University of Helsinki, HUS Comprehensive Cancer Center



Date: 2020-04-15
Language: eng
Number of pages: 8
Belongs to series: Frontiers in Immunology
ISSN: 1664-3224
DOI: https://doi.org/10.3389/fimmu.2020.00586
URI: http://hdl.handle.net/10138/315808
Abstract: Elevated serum ferritin levels occur due to iron overload or during inflammation and macrophage activation. A correlation of high serum ferritin levels with increased mortality after alloSCT has been suggested by several retrospective analyses as well as by two smaller prospective studies. This prospective multicentric study aimed to study the association of ferritin serum levels before start of conditioning with alloSCT outcome. Patients with acute leukemia, lymphoma or MDS receiving a matched sibling alloSCT for the first time were considered for inclusion, regardless of conditioning. A comparison of outcomes between patients with high and low ferritin level was performed using univariate analysis and multivariate analysis using cause-specific Cox model. Twenty centers reported data on 298 alloSCT recipients. The ferritin cut off point was determined at 1500 mu g/l (median of measured ferritin levels). In alloSCT recipients with ferritin levels above cut off measured before the start of conditioning, overall survival (HR = 2.5, CI = 1.5-4.1, p = 0.0005) and progression-free survival (HR = 2.4, CI = 1.6-3.8, p <0.0001) were inferior. Excess mortality in the high ferritin group was due to both higher relapse incidence (HR = 2.2, CI = 1.2-3.8, p = 0.007) and increased non-relapse mortality (NRM) (HR = 3.1, CI = 1.5-6.4, p = 0.002). NRM was driven by significantly higher infection-related mortality in the high ferritin group (HR = 3.9, CI = 1.6-9.7, p = 0.003). Acute and chronic GVHD incidence or severity were not associated to serum ferritin levels. We conclude that ferritin levels can serve as routine laboratory biomarker for mortality risk assessment before alloSCT.
Subject: transplantation
stem cell
immunology
biomarker
iron metabolism
ferritin
ACUTE MYELOID-LEUKEMIA
DISEASE RISK INDEX
IRON OVERLOAD
CELL TRANSPLANTATION
INFECTION
DIAGNOSIS
ALBUMIN
IMPACT
3122 Cancers
3111 Biomedicine
1182 Biochemistry, cell and molecular biology
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