TY - JOUR
T1 - Impact of Hyperferritinemia on the Outcome of Reduced-Intensity Conditioning Allogeneic Hematopoietic Cell Transplantation for Lymphoid Malignancies
AU - Barba, Pere
AU - Valcárcel, David
AU - Pérez-Simón, José Antonio
AU - Fernández-Avilés, Francesc
AU - Piñana, José Luis
AU - Martino, Rodrigo
AU - López-Anglada, Lucía
AU - Rovira, Montserrat
AU - Garcia-Cadenas, Irene
AU - Novelli, Silvana
AU - Carreras, Enric
AU - López Corral, Lucía
AU - Sierra, Jorge
PY - 2013/4/1
Y1 - 2013/4/1
N2 - 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.
AB - 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.
KW - Ferritin
KW - HCT comorbidity index
KW - Hematopoietic cell transplantation
KW - Lymphoma
KW - Reduced-intensity conditioning
KW - RIC
U2 - 10.1016/j.bbmt.2012.12.018
DO - 10.1016/j.bbmt.2012.12.018
M3 - Article
VL - 19
SP - 597
EP - 601
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 4
ER -