| Title | Serum ferritin as risk factor for sinusoidal obstruction syndrome of the liver in patients undergoing hematopoietic stem cell transplantation. | | Author(s) | Maradei SC, Maiolino A, de Azevedo AM, Colares M, Bouzas LF, Nucci M | | Institution | Bone Marrow Transplantation Center (CEMO), Instituto Nacional de Cancer (INCA), Rio de Janeiro, Brazil. | | Source | Blood 2009 Apr 28. | | Abstract | Hepatic sinusoidal obstruction syndrome (SOS) is a serious complication in hematopoietic stem cell transplant (HSCT) recipients. In order to determine the impact of pre-transplant hyperferritinemia on the risk of SOS after HSCT, we retrospectively studied 427 HSCT recipients (179 autologous and 248 allogeneic). Serum ferritin levels were measured before transplant. Patients with and without a diagnosis of SOS were compared regarding demographics, underlying disease, transplant characteristics, receipt of imatinib, busulfan, total body irradiation, gemtuzumab, vancomycin, acyclovir, methotrexate, and baseline serum ferritin. Univariate and multivariate (stepwise logistic regression) analyses were performed. SOS was diagnosed in 88 patients (21%) at a median of 10 days (2 to 29) post-transplant. By multivariate analysis, allogeneic HSCT (odds ratio [OR] = 8.25, 95% confidence interval [95% CI] 3.31 - 20.57), receipt of imatinib (OR = 2.60, 95% CI 1.16 - 5.84), receipt of busulfan (OR = 2.18, 95% CI 1.25 - 3.80) and ferritin serum level >1000 ng/dl (OR = 1.78, 95% CI 1.02 - 3.08) were risk factors for SOS. A ferritin serum level >1,000 ng/dl in the pre-transplant period is an independent risk factor for SOS. The results suggest the need for prospective studies addressing the use of iron chelation in the pre-transplant period. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19401560 |
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