Article (Scientific journals)
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 *
Cremers, Eline; de Witte, Theo; de Wreede, Liesbeth et al.
2019In Leukemia and Lymphoma, 60, p. 2404-2414
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Keywords :
MDS; allogeneic stem cell transplantation; transfusions; phlebotomies; chelation therapy
Abstract :
[en] 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. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
Disciplines :
Hematology
Author, co-author :
Cremers, Eline
de Witte, Theo;  Radboud University Medical Centre, Nijmegen, Netherlands
de Wreede, Liesbeth;  Leiden University Medical Centre, Leiden, Netherlands
Eikema, Diderik-Jan;  EBMT Statistical Unit Data Office Leiden, Leiden, Netherlands
Koster, Linda;  EBMT Data Office Leiden, Leiden, Netherlands
van Biezen, Anja;  EBMT Data Office Leiden, Leiden, Netherlands
Finke, Jürgen;  Department of Hematology/Oncology & Stem Cell Transplantation, University of Freiburg, Freiburg, Germany
Socié, Gerard;  Hospital St. Louis, Paris, France
Beelen, Dietrich;  University Hospital, Essen, Germany
Maertens, Johan;  University Hospital Gasthuisberg, Leuven, Belgium
Nagler, Arnon;  Chaim Sheba Medical Center, Tel-Hashomer, Israel
Kobbe, Guido;  Department of Hematology, Oncology and Clinical Immunology, Heinrich Heine Universitaet, Düsseldorf, Germany
Ziagkos, Dimitris;  EBMT Statistical Unit Data Office Leiden, Leiden, Netherlands
Itälä-Remes, Maija;  HUCH Comprehensive Cancer Center, Helsinki, Finland
Gedde-Dahl, Tobias;  Oslo University Hospital, Rikshospitalet, Oslo, Norway
Sierra, Jorge;  Hospital Santa Creu i Sant Pau, Barcelona, Spain
Niederwieser, Dietger;  University Hospital Leipzig, Leipzig, Germany
Ljungman, Per;  Karolinska University Hospital, Stockholm, Sweden
Beguin, Yves  ;  Université de Liège - ULiège > Département des sciences cliniques > Hématologie
Ozkurt, Zubeyde Nur;  Faculty of Medicine, Gazi University, Ankara, Turkey
Anagnostopoulos, Achilles;  George Papanicolaou General Hospital, Thessaloniki, Greece
Jindra, Pindra;  Charles University Hospital, Pilsen, Czech Republic
Robin, Marie;  Hospital St. Louis, Paris, France
Kröger, Nicolaus;  University Hospital Eppendorf, Hamburg, Germany
More authors (14 more) Less
Language :
English
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 *
Publication date :
2019
Journal title :
Leukemia and Lymphoma
ISSN :
1042-8194
eISSN :
1029-2403
Publisher :
Taylor and Francis Ltd
Volume :
60
Pages :
2404-2414
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 16 November 2019

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