High Prevalence of Iron Overload in Adult Allogeneic Hematopoietic Cell Transplant Survivors

Navneet S. Majhail, Todd DeFor, Hillard M. Lazarus, Linda J. Burns

Research output: Contribution to journalArticlepeer-review

44 Scopus citations

Abstract

Allogeneic hematopoietic cell transplant (HCT) recipients frequently need red blood cell transfusions, and can be at risk for developing iron overload. We studied the prevalence of iron overload in 56 adult allogeneic HCT patients who had survived for a median of 28 (range: 12-151) months from transplant. Patients were initially screened with serum ferritin, and those with serum ferritin >1000 ng/mL underwent R2 magnetic resonance imaging (MRI) of the liver, a sensitive and specific noninvasive imaging technique to measure liver iron concentration (LIC). Iron overload was defined as LIC above normal (>1.8 mg/g dry weight). Nineteen patients had serum ferritin >1000 ng/mL with a median LIC of 7.0 (range: 1.8-28.3) mg/g. The overall prevalence of iron overload was 32% (95% confidence intervals, 20%-46%). The LIC on MRI was moderately correlated with serum ferritin (ρ = .47). Iron overload is a frequent complication of allogeneic transplantation. Serum ferritin is a good screening test but does not reliably predict tissue iron overload, and estimation of LIC should be considered before initiating therapy. More studies are needed to determine the impact of iron overload on long-term morbidity and mortality in allogeneic transplant survivors.

Original languageEnglish (US)
Pages (from-to)790-794
Number of pages5
JournalBiology of Blood and Marrow Transplantation
Volume14
Issue number7
DOIs
StatePublished - Jul 2008

Bibliographical note

Funding Information:
This study was funded by grant support from Novartis Pharmaceuticals Corporation, East Hanover, NJ. We gratefully acknowledge the support provided by the Clinical Trials Office, University Of Minnesota Cancer Center, and by the staff and patients of the University of Minnesota Blood and Marrow Transplant Program.

Keywords

  • Allogeneic stem cell transplantation
  • Ferritin
  • Iron overload
  • Late complications
  • Liver iron concentration

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