RT Journal Article
T1 Association of Serum Ferritin Levels Before Start of Conditioning With Mortality After alloSCT - A Prospective, Non-interventional Study of the EBMT Transplant Complications Working Party.
A1 Penack, Olaf
A1 Peczynski, Christophe
A1 van-der-Werf, Steffie
A1 Finke, Jürgen
A1 Ganser, Arnold
A1 Schoemans, Helene
A1 Pavlu, Jiri
A1 Niittyvuopio, Riitta
A1 Schroyens, Wilfried
A1 Kaynar, Leylagül
A1 Blau, Igor W
A1 van-der-Velden, Walter J F M
A1 Sierra, Jorge
A1 Cortelezzi, Agostino
A1 Wulf, Gerald
A1 Turlure, Pascal
A1 Rovira, Montserrat
A1 Ozkurt, Zubeydenur
A1 Pascual-Cascon, Maria J
A1 Moreira, Maria C
A1 Clausen, Johannes
A1 Greinix, Hildegard
A1 Duarte, Rafael F
A1 Basak, Grzegorz W
K1 Biomarker
K1 Ferritin
K1 Immunology
K1 Iron metabolism
K1 Stem cell
K1 Transplantation
AB Elevated serum ferritin levels occur due to iron overload or during inflammation and macrophage activation. A correlation of high serum ferritin levels with increased mortality after alloSCT has been suggested by several retrospective analyses as well as by two smaller prospective studies. This prospective multicentric study aimed to study the association of ferritin serum levels before start of conditioning with alloSCT outcome. Patients with acute leukemia, lymphoma or MDS receiving a matched sibling alloSCT for the first time were considered for inclusion, regardless of conditioning. A comparison of outcomes between patients with high and low ferritin level was performed using univariate analysis and multivariate analysis using cause-specific Cox model. Twenty centers reported data on 298 alloSCT recipients. The ferritin cut off point was determined at 1500 μg/l (median of measured ferritin levels). In alloSCT recipients with ferritin levels above cut off measured before the start of conditioning, overall survival (HR = 2.5, CI = 1.5-4.1, p = 0.0005) and progression-free survival (HR = 2.4, CI = 1.6-3.8, p< 0.0001) were inferior. Excess mortality in the high ferritin group was due to both higher relapse incidence (HR = 2.2, CI = 1.2–3.8, p = 0.007) and increased non-relapse mortality (NRM) (HR = 3.1, CI = 1.5–6.4, p = 0.002). NRM was driven by significantly higher infection-related mortality in the high ferritin group (HR = 3.9, CI = 1.6–9.7, p = 0.003). Acute and chronic GVHD incidence or severity were not associated to serum ferritin levels. We conclude that ferritin levels can serve as routine laboratory biomarker for mortality risk assessment before alloSCT.
PB Frontiers Research Foundation
YR 2020
FD 2020-04-15
LK http://hdl.handle.net/10668/15470
UL http://hdl.handle.net/10668/15470
LA en
NO Penack O, Peczynski C, van der Werf S, Finke J, Ganser A, Schoemans H, et al.  Association of Serum Ferritin Levels Before Start of Conditioning With Mortality After alloSCT - A Prospective, Non-interventional Study of the EBMT Transplant Complications Working Party. Front Immunol. 2020 Apr 15;11:586
NO JP acknowledges the support of the Imperial NIHR-BCR. OP acknowledges the support of José Carreras Leukämie-Stiftung (11R2016 and 3R2019), Deutsche Krebshilfe (70113519), and Deutsche Forschungsgemeinschaft (PE 1450/7-1).
DS RISalud
RD Apr 12, 2025