Impact of prohepcidin levels and iron parameters on early post-transplantation toxicities

Figures & data

Table 1. Clinical characteristics of patients

	Allogeneic (n = 100)
Gender (male/female)	64/36
Median age (years) (range)	27·5 (16–63)
Disease
ALL	21 (21%)
AML	43 (43%)
SAA	13 (13%)
CML	6 (6%)
MDS	3 (3%)
Multiple myeloma	3 (3%)
Hodgkin’s disease	7 (7%)
NHL	4 (4%)
Time from diagnosis to stem cell transplantation (days) (range)	239 (38–2285)
Conditioning regimen
Myeloablative	73 (73%)
Non-myeloablative	27 (27%)
Disease status prior to transplantation
First CR	34 (34%)
⩾ second CR	22 (22%)
PR	4 (4%)
Relapsed/refractory	20 (20%)
Others	20 (20%)
Median CD34^+ cells infused (×10^6/kg)	3·99 (range 1·22–17·04)
Median days of engraftment
Neutrophil (>500/mm^3)	18 days (range 10–32)
Platelets (>20000/mm^3)	14 days (range 0–54)
Pre-transplantation mean values of variables
SI (μg/dl)	121·52±81·41
SIBC (μg/dl)	255·86±73·17
TS (%)	53·80±51·36
Ferritin (μg/dl)	1222·25±1304·37
Prohepcidin (ng/ml)	137·07±54·69
IL-6 (pg/ml)	36·99±56·23
ESR (mm/h)	54·04±41·31
CRP (mg/dl)	25·06±46·80
Fibrinogen (mg/dl)	350·59±151·78

Note: ^*Others include 13 patients with SAA, 2 patients with MDS, and 5 patients with CML (3 patients in chronic phase and 2 in blastic phase).

^‡Platelet engraftment day was defined as ‘0’ when platelet count was never below 20000/mm³ after SCT and the patient did not receive any platelet transfusion.

ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; MDS, myelodysplastic syndrome; CML, chronic myelogenous leukemia; SAA, severe aplastic anemia; NHL, non-Hodgkin's lymphoma; CR, complete remission; PR, partial remission; SI, serum iron; SIBC, serum iron binding capacity; TS, transferin saturation; IL-6, interleukin-6; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein.

Table 2. Correlation between serum iron, ferritin, prohepcidin, IL-6, CRP levels, and early post-transplant complications in allogeneic stem cell transplantation

	Serum iron	Ferritin	Prohepcidin	IL-6	CRP
Mucositis	P = 0·316	P = 0·183	P = 0·060	P = 0·596	P = 0·965
	r = −0·104	r = 0·137	r = −0·190	r = 0·054	r = −0·005
Liver	P = 0·015	P = 0·394	P = 0·112	P = 0·036	P = 0·042
	r = 0·249	r = 0·088	r = −0·161	r = 0·211	r = 0·207
SOS	P = 0·535	P = 0·005	P = 0·474	P = 0·422	P = 0·027
	r = 0·064	r = 0·287	r = −0·073	r = 0·082	r = 0·225
Pulmonary	P = 0·940	P = 0·348	P = 0·313	P = 0·009	P = 0·474
	r = 0·008	r = 0·097	r = −0·102	r = 0·262	r = 0·074
Cardiac	P = 0·530	P = 0·385	P = 0·545	P = 0·349	P = 0·957
	r = −0·065	r = −0·090	r = 0·062	r = −0·095	r = 0·006
Renal	P = 0·063	P = 0·432	P = 0·517	P = 0·641	P = 0·963
	r = 0·191	r = −0·081	r = −0·066	r = −0·048	r = 0·005
Days with febrile neutropenia	P = 0·695	P = 0·058	P = 0·003	P = 0·023	P = 0·17
	r = −0·041	r = 0·195	r = −0·298	r = 0·230	r = 0·243
Neutrophil engraftment day	P = 0·572	P = 0·012	P = 0·783	P = 0·993	P = 0·859
	r = 0·060	r = −0·259	r = −0·028	r = 0·001	r = −0·019
Platelet engraftment day	P = 0·007	P = 0·098	P = 0·849	P = 0·995	P = 0·626
	r = 0·294	r = −0·181	r = −0·021	r = −0·001	r = 0·054
No. of erythrocyte transfusion	P = 0·000	P = 0·010	P = 0·080	P = 0·076	P = 0·023
	r = 0·366	r = 0·264	r = −0·178	r = 0·181	r = 0·233
No. of platelet transfusion	P = 0·011	P = 0·015	P = 0·119	P = 0·018	P = 0·005
	r = 0·262	r = 0·251	r = −0·159	r = 0·241	r = 0·284

Statistically significant values are indicated in bold.

Figure 1. Overall survival in allogeneic stem cell transplantation.

Figure 2. Overall survival in allogeneic stem cell transplantation according to ferritin levels (<500 ng/ml versus 500–1500 ng/ml versus ⩾1500 ng/ml).