Haematology Department, Hospital de Sant Pau, Autonomous University of Barcelona, Barcelona, Spain

Correspondence to: Dr A Altès, Servei d'Hematología Clínica, Hospital de la Santa Creu i Sant Pau, Sant Antoni M^a Claret 167. 08025 Barcelona, Spain

Iron overload (IO) is associated with free radical generation and tissue damage. Our main objective was to ascertain if very high levels (VHL) of ferritin (3000 g/l) and transferrin saturation (TS) 100% during conditioning had an impact on overall survival (OS) and transplant-related mortality (TRM) after a haematopoietic stem cell transplantation (HSCT). Levels of ferritin and TS were measured at days -7 and -4, respectively, in 25 patients who underwent HSCT after CY/TBI. The group consisted of 20 men and five women with a median age of 40 years. Fifteen patients were autotransplanted and 10 allotransplanted. Nine of them had a diagnosis of AL, six of CML and 10 of lymphoma. Thirteen of them were in early and 12 in advanced status of disease. VHL of ferritin and TS 100% were associated with a decreased OS (P = 0.001 and P = 0.006, respectively) and an increased TRM (P = 0.003 and P = 0.004, respectively) in univariate survival analysis. Both variables remained significant at multivariate analysis for OS (P = 0.03 and 0.02, respectively) and TS was an independent factor for TRM (P = 0.01). Ferritin was very close to achieving statistical significance for TRM (P = 0.06) in multivariate analysis. In conclusion, VHL of ferritin and TS 100% at conditioning are associated with an increase in toxic deaths after transplant.

Bone Marrow Transplantation (2002) 29, 987-989. DOI:10.1038/sj/bmt/1703570

iron; transferrin saturation; ferritin; survival; TRM; HSCT