Impact of Hyperferritinemia on the Outcome of Reduced-Intensity Conditioning Allogeneic Hematopoietic Cell Transplantation for Lymphoid Malignancies

Pere Barba, David Valcárcel, José Antonio Pérez-Simón, Francesc Fernández-Avilés, José Luis Piñana, Rodrigo Martino, Lucía López-Anglada, Montserrat Rovira, Irene Garcia-Cadenas, Silvana Novelli, Enric Carreras, Lucía López Corral, Jorge Sierra

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Abstract

Hyperferritinemia has been associated with adverse outcomes after allogeneic hematopoietic cell transplantation (allo-HCT) with myeloablative conditioning. However, its characteristics and impact on the outcome in the reduced-intensity conditioning (RIC) and in the lymphoid malignancy settings are far from clear. The study includes 201 adult patients undergoing allo-HCT with RIC (allo-RIC) for lymphoid malignancies with a median follow-up for survivors of 52 months (range, 3 to 123). Median serum ferritin level at allo-RIC was 379 ng/mL (range, 4 to 10,790). In the multivariate analysis, patients with hyperferritinemia at transplantation (>399 ng/mL) showed lower 4-year overall survival (hazard ratio [HR], 1.8 [95% confidence interval {CI}, 1.2 to 2.8]; P = .008), higher nonrelapse mortality (NRM) (HR, 1.8 [95% CI, 1.1 to 3.2]; P = .03), and higher infection-related mortality (HR, 2.3 [95% CI, 1.1 to 4.8]; P = .02) than patients without hyperferritinemia. Neutrophil and platelet engraftment and 100-day NRM were similar between both groups. The adverse outcome associated with hyperferritinemia seemed higher in patients without major comorbidities and was not influenced by the elevation of acute phase reactants. Our results indicate that high ferritin levels at HCT are associated with an adverse outcome after allo-RIC in patients with lymphoid malignancies. © 2013 American Society for Blood and Marrow Transplantation.
Original languageEnglish
Pages (from-to)597-601
JournalBiology of Blood and Marrow Transplantation
Volume19
Issue number4
DOIs
Publication statusPublished - 1 Apr 2013

Keywords

  • Ferritin
  • HCT comorbidity index
  • Hematopoietic cell transplantation
  • Lymphoma
  • Reduced-intensity conditioning
  • RIC

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    Barba, P., Valcárcel, D., Pérez-Simón, J. A., Fernández-Avilés, F., Piñana, J. L., Martino, R., López-Anglada, L., Rovira, M., Garcia-Cadenas, I., Novelli, S., Carreras, E., López Corral, L., & Sierra, J. (2013). Impact of Hyperferritinemia on the Outcome of Reduced-Intensity Conditioning Allogeneic Hematopoietic Cell Transplantation for Lymphoid Malignancies. Biology of Blood and Marrow Transplantation, 19(4), 597-601. https://doi.org/10.1016/j.bbmt.2012.12.018