Association of iron overload with allogeneic hematopoietic cell transplantation outcomes: A prospective cohort study using R2-MRI-measured liver iron content

Bryan J. Trottier, Linda J. Burns, Todd E. De For, Sarah Cooley, Navneet S. Majhail

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

Using liver magnetic resonance imaging (R2-MRI) to quantify liver iron content (LIC), we conducted a prospective cohort study to determine the association between iron overload and adult allogeneic hematopoietic cell transplantation (HCT) outcomes. Patients received pretransplant ferritin measurements; patients with ferritin >500 ng/mL underwent R2-MRI. Patients were defined as no iron overload (N = 28) and iron overload (LIC >1.8 mg/g; N = 60). Median LIC in the iron-overload group was 4.3 mg/g (range, 1.9-25.4). There was no difference in the 1-year probability of overall survival, nonrelapse mortality, relapse, acute or chronic graft-versus-host disease, organ failure, infections, or hepatic veno-occlusive disease between groups. We also found no difference in the cumulative incidence of a composite end point of nonrelapse mortality, any infection, organ failure, or hepatic veno-occlusive disease (1-year cumulative incidence, 71% vs 80%; P =.44). In multivariate analyses, iron-overload status did not impact risks of overall mortality (relative risk = 2.3; 95% confidence interval, 0.9-5.9; P =.08). In conclusion, we found no association between pretransplant iron overload and allogeneic HCT outcomes. Future studies in this population should use LIC to define iron overload instead of ferritin.

Original languageEnglish (US)
Pages (from-to)1678-1684
Number of pages7
JournalBlood
Volume122
Issue number9
DOIs
StatePublished - Aug 29 2013

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