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Rust and corrosion in hematopoietic stem cell transplantation: the problem of iron and oxidative stress

Bone Marrow Transplantation volume 34, pages 561–571 (2004)Cite this article

Summary:

Iron overload is a common acute and long-term event associated with autologous and allogeneic hematopoietic stem cell transplantation (HSCT). In a state of iron excess, free iron becomes available to catalyze the conversion of reactive oxygen species (ROS) intermediates such as superoxide anion (O2•−) and hydrogen peroxide (H2O2) to highly toxic free radicals such as hydroxyl radical (OH•). ROS may help to promote chronic liver disease, sinusoidal obstruction syndrome, idiopathic pneumonia syndrome and bacterial, fungal and other opportunistic infections. Phlebotomy has been effectively and safely used to deplete excess iron stores post-HSCT in thalassemic and other iron-overloaded patients. Intracellular iron levels may also be decreased through pharmacologic chelating agents, while antioxidants such as N-acetylcysteine, glutamine (glutathione precursor) and captopril have been shown to replenish glutathione redox potential and scavenge free radicals. A better understanding of the mechanisms involved in the iron-generated pro-oxidant state associated with HSCT will likely lead to reduced toxicity and improved patient outcomes.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Medicine, Hematopoietic Stem Cell Transplant Program, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    A M Evens, J Mehta & L I Gordon

  2. The Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA

    A M Evens, J Mehta & L I Gordon

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  1. A M Evens
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  2. J Mehta
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  3. L I Gordon
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Correspondence to L I Gordon.

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Evens, A., Mehta, J. & Gordon, L. Rust and corrosion in hematopoietic stem cell transplantation: the problem of iron and oxidative stress. Bone Marrow Transplant 34, 561–571 (2004). https://doi.org/10.1038/sj.bmt.1704591

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  • DOI: https://doi.org/10.1038/sj.bmt.1704591

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