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Hyperferritinemia after adult allogeneic hematopoietic cell transplantation: quantification of iron burden by determining non-transferrin-bound iron

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Abstract

Iron overload is a common complication in allogeneic hematopoietic cell transplantation (HCT). We studied the prevalence of iron overload using serum ferritin from 122 allogeneic HCT survivors who had survived a median of 1259 (range 134–4261) days. We also quantified iron overload by determining non-transferrin-bound iron (NTBI), which reflects iron overload more directly than ferritin, and compared the results with those of the ferritin assay. Fifty-two patients (43 %) showed hyperferritinemia (HF) (serum ferritin >1000 ng/mL), and there was a moderate correlation between serum ferritin and the number of transfused red blood cell units (ρ = 0.71). In multivariate analyses, HF was a significant risk factor for liver dysfunction (P = 0.0001) and diabetes (P = 0.02), and was related to a lesser extent with performance status (P = 0.08). There was a significant correlation between serum ferritin and NTBI (ρ = 0.59); however, the association of NTBI with these outcomes was weaker than that of serum ferritin. In conclusion, serum ferritin is a good surrogate marker of iron overload after allogeneic HCT, and reflects organ damage more accurately than NTBI.

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Acknowledgments

This study was supported in part by a Grant-in-Aid 11103742 from the Ministry of Health, Labor and Welfare of Japan to K.M.

Conflict of interest

K.S. and Y.K. have received research funding from Novartis Pharma. The remaining authors declare no competing financial interests.

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Authors and Affiliations

  1. Department of Hematology, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan

    Tatsunori Goto, Yoshihiro Inamoto, Sonoko Kamoshita, Emi Yokohata, Daisuke Koyama, Koichi Onodera, Aika Seto, Keisuke Watanabe, Nobuhiko Imahashi, Shokichi Tsukamoto, Yukiyasu Ozawa & Koichi Miyamura

  2. Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan

    Katsuya Ikuta & Yutaka Kohgo

  3. Department of Gastrointestinal Immunology and Regenerative Medicine, Asahikawa Medical University, Asahikawa, Japan

    Katsunori Sasaki

  4. Department of Pathology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Masafumi Ito

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  1. Tatsunori Goto
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  2. Katsuya Ikuta
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Correspondence to Tatsunori Goto.

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Goto, T., Ikuta, K., Inamoto, Y. et al. Hyperferritinemia after adult allogeneic hematopoietic cell transplantation: quantification of iron burden by determining non-transferrin-bound iron. Int J Hematol 97, 125–134 (2013). https://doi.org/10.1007/s12185-012-1252-1

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  • DOI: https://doi.org/10.1007/s12185-012-1252-1

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