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Iron Overload Does Not Worsen Stem Cell Transplant Outcomes

No significant increase in iron accumulation after hematopoietic stem cell transplantation in leukemia

FRIDAY, March 23 (HealthDay News) -- Although iron overload before hematopoietic stem cell transplantation (HSCT) is common, iron does not accumulate after transplantation and is not associated with adverse outcomes in patients with leukemia or myelodysplastic syndrome, according to a study published online March 12 in the American Journal of Hematology.

Philippe Armand, M.D., Ph.D., from the Dana-Farber Cancer Institute in Boston, and colleagues prospectively investigated serum iron parameters and performed liver and cardiac magnetic resonance imaging in 45 patients with acute leukemia or myelodysplastic syndrome undergoing myeloablative allogeneic HSCT.

In the 12 months following HSCT, the researchers observed no significant increases in ferritin levels or iron content in the liver or heart. While noting that pre-transplantation iron overload was frequent, as determined by liver iron content, and that serum ferritin appeared to have prognostic significance, iron overload was not linked to increased mortality, relapse, or graft-versus-host disease.

"While iron overload is indeed very common in this population, likely related mostly to prior transfusion burden, there does not appear to be a significant accumulation of iron in patients after transplantation," Armand and colleagues conclude. "These results raise the possibility that the adverse prognostic impact of pre-HSCT hyperferritinemia may be related to factors independent of iron overload."

The study was funded in part by Novartis Oncology.

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