Iron Overload during Follow-up after Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation in Patients with High-Risk Neuroblastoma
Journal of Korean Medical Science
;
: 363-369, 2012.
Article
in English
| WPRIM
| ID: wpr-143930
ABSTRACT
Multiple RBC transfusions inevitably lead to a state of iron overload before and after high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT). Nonetheless, iron status during post-SCT follow-up remains unknown. Therefore, we investigated post-SCT ferritin levels, factors contributing to its sustained levels, and organ functions affected by iron overload in 49 children with high-risk neuroblastoma who underwent tandem HDCT/autoSCT. Although serum ferritin levels gradually decreased during post-SCT follow-up, 47.7% of the patients maintained ferritin levels above 1,000 ng/mL at 1 yr after the second HDCT/autoSCT. These patients had higher serum creatinine (0.62 vs 0.47 mg/mL, P = 0.007) than their counterparts (< 1,000 ng/mL). Post-SCT transfusion amount corresponded to increased ferritin levels at 1 yr after the second HDCT/autoSCT (P < 0.001). A lower CD34+ cell count was associated with a greater need of RBC transfusion, which in turn led to a higher serum ferritin level at 1 yr after HDCT/autoSCT. The number of CD34+ cells transplanted was an independent factor for ferritin levels at 1 yr after the second HDCT/autoSCT (P = 0.019). Consequently, CD34+ cells should be transplanted as many as possible to prevent the sustained iron overload after tandem HDCT/autoSCT and consequent adverse effects.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Transplantation, Autologous
/
Triazoles
/
Benzoates
/
Blood Transfusion
/
Antineoplastic Combined Chemotherapy Protocols
/
Iron Chelating Agents
/
Retrospective Studies
/
Risk Factors
/
Follow-Up Studies
/
Antigens, CD34
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Child
/
Child, preschool
/
Humans
/
Infant
Language:
English
Journal:
Journal of Korean Medical Science
Year:
2012
Type:
Article
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