IRON-CHELATING THERAPY IMPROVES OUTCOME OF ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION IN MDS
(Abstract release date: 05/19/16)
EHA Library. Li C. 06/09/16; 133077; E1528
Prof. Dr. Caixia Li
Contributions
Contributions
Abstract
Abstract: E1528
Type: Eposter Presentation
Background
Iron overload (IO) is general among patients with myelodysplastic syndrome (MDS). IO increased the non-relapse mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Therefore, the application of iron chelating therapy in allo-HSCT attracts the extensive attention recently. r severe HC following HSCT.
Aims
To investigate the effect of iron chelating therapy on hematopoietic reconstitution and related complications of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myelodysplastic syndrome (MDS).
Methods
Various clinical parameters were analyzed retrospectivly in 57 MDS patients with iron overload (IO)who received allogeneic transplantation. According to the level of serum ferritin (SF) before transplantation, we divided the patients into two groups: the effective treatment group (19 cases, SF<1000ng/ml) and iron overload group (38 cases, SF≥1000ng/ml).
Results
(1) 30/57 cases were received iron chelating treatment, 19/30 (63%) cases obtained obvious curative effect, the SF level before transplantation was<1000ng/ml, the median was 561(223-846) ng/ml. The effort of other 11/30 (37%) cases was not obvious, with the SF level before transplantation was ≥1000ng/ml,the median was 1262(1100-2352) ng/ml. 27/57 patients didn't received iron chelating therapy before transplantation, the SF level before transplantation was≥1000ng/ml,the median was 1540(1320-3112) ng/ml. (2) The rate of fully-engraftment in the effective treatment group and iron overload group was 19/19 (100%) and 34/38 (89%). And the latter group had 4/38 (11%) cases failed the hematopoietic reconstitution.The medium time of myeloid and platelet reconstitution of the 19 cases of effective treatment group was (12±2) and (16±6) days respectively, while those of 34 cases of iron overload group was (13±3) and (18±6) days. The hematopoietic reconstruction was shorten in the former group, however the difference between the two groups had no statistical significance (P=0.441, P=0.579). (3) The infection rate of the effective treatment group and iron overload group was 7/19 (37%) patients and 28/34 (82%) patients respectively. The risk of infection of the effective treatment group was decreased significantly (P=0.002). (4) The incidence of aGVHD of the effective treatment group was 5/19 (26%) patients, all of which were I-II degree. The incidence of aGVHD of iron load group was 22/34 (65%) cases, with 16 cases of I-II degree, 6 cases of III-IV degree. The risk of aGVHD in the effective treatment group was significantly decreased (P=0.01). (5) The median disease-free survival（DFS）in effective treatment group was 28.9（0.3-89.5）and 21.2（0.1-81.0）months in iron load group during a median follow-up period of 22.0 (0.1-89.0) months.The DFS of effective treatment group was prolonged (P=0.053).
Conclusion
Effective iron chelating therapy before transplantation was helpful to hematopoietic reconstitution, and significantly reduced the incidence and degree of infection and aGVHD, decreased transplantation related mortality(TRM) and prolonged DFS, thereby improved the success rate of transplantation in MDS.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Iron chelation, Myelodysplasia
Type: Eposter Presentation
Background
Iron overload (IO) is general among patients with myelodysplastic syndrome (MDS). IO increased the non-relapse mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Therefore, the application of iron chelating therapy in allo-HSCT attracts the extensive attention recently. r severe HC following HSCT.
Aims
To investigate the effect of iron chelating therapy on hematopoietic reconstitution and related complications of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myelodysplastic syndrome (MDS).
Methods
Various clinical parameters were analyzed retrospectivly in 57 MDS patients with iron overload (IO)who received allogeneic transplantation. According to the level of serum ferritin (SF) before transplantation, we divided the patients into two groups: the effective treatment group (19 cases, SF<1000ng/ml) and iron overload group (38 cases, SF≥1000ng/ml).
Results
(1) 30/57 cases were received iron chelating treatment, 19/30 (63%) cases obtained obvious curative effect, the SF level before transplantation was<1000ng/ml, the median was 561(223-846) ng/ml. The effort of other 11/30 (37%) cases was not obvious, with the SF level before transplantation was ≥1000ng/ml,the median was 1262(1100-2352) ng/ml. 27/57 patients didn't received iron chelating therapy before transplantation, the SF level before transplantation was≥1000ng/ml,the median was 1540(1320-3112) ng/ml. (2) The rate of fully-engraftment in the effective treatment group and iron overload group was 19/19 (100%) and 34/38 (89%). And the latter group had 4/38 (11%) cases failed the hematopoietic reconstitution.The medium time of myeloid and platelet reconstitution of the 19 cases of effective treatment group was (12±2) and (16±6) days respectively, while those of 34 cases of iron overload group was (13±3) and (18±6) days. The hematopoietic reconstruction was shorten in the former group, however the difference between the two groups had no statistical significance (P=0.441, P=0.579). (3) The infection rate of the effective treatment group and iron overload group was 7/19 (37%) patients and 28/34 (82%) patients respectively. The risk of infection of the effective treatment group was decreased significantly (P=0.002). (4) The incidence of aGVHD of the effective treatment group was 5/19 (26%) patients, all of which were I-II degree. The incidence of aGVHD of iron load group was 22/34 (65%) cases, with 16 cases of I-II degree, 6 cases of III-IV degree. The risk of aGVHD in the effective treatment group was significantly decreased (P=0.01). (5) The median disease-free survival（DFS）in effective treatment group was 28.9（0.3-89.5）and 21.2（0.1-81.0）months in iron load group during a median follow-up period of 22.0 (0.1-89.0) months.The DFS of effective treatment group was prolonged (P=0.053).
Conclusion
Effective iron chelating therapy before transplantation was helpful to hematopoietic reconstitution, and significantly reduced the incidence and degree of infection and aGVHD, decreased transplantation related mortality(TRM) and prolonged DFS, thereby improved the success rate of transplantation in MDS.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Iron chelation, Myelodysplasia
Abstract: E1528
Type: Eposter Presentation
Background
Iron overload (IO) is general among patients with myelodysplastic syndrome (MDS). IO increased the non-relapse mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Therefore, the application of iron chelating therapy in allo-HSCT attracts the extensive attention recently. r severe HC following HSCT.
Aims
To investigate the effect of iron chelating therapy on hematopoietic reconstitution and related complications of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myelodysplastic syndrome (MDS).
Methods
Various clinical parameters were analyzed retrospectivly in 57 MDS patients with iron overload (IO)who received allogeneic transplantation. According to the level of serum ferritin (SF) before transplantation, we divided the patients into two groups: the effective treatment group (19 cases, SF<1000ng/ml) and iron overload group (38 cases, SF≥1000ng/ml).
Results
(1) 30/57 cases were received iron chelating treatment, 19/30 (63%) cases obtained obvious curative effect, the SF level before transplantation was<1000ng/ml, the median was 561(223-846) ng/ml. The effort of other 11/30 (37%) cases was not obvious, with the SF level before transplantation was ≥1000ng/ml,the median was 1262(1100-2352) ng/ml. 27/57 patients didn't received iron chelating therapy before transplantation, the SF level before transplantation was≥1000ng/ml,the median was 1540(1320-3112) ng/ml. (2) The rate of fully-engraftment in the effective treatment group and iron overload group was 19/19 (100%) and 34/38 (89%). And the latter group had 4/38 (11%) cases failed the hematopoietic reconstitution.The medium time of myeloid and platelet reconstitution of the 19 cases of effective treatment group was (12±2) and (16±6) days respectively, while those of 34 cases of iron overload group was (13±3) and (18±6) days. The hematopoietic reconstruction was shorten in the former group, however the difference between the two groups had no statistical significance (P=0.441, P=0.579). (3) The infection rate of the effective treatment group and iron overload group was 7/19 (37%) patients and 28/34 (82%) patients respectively. The risk of infection of the effective treatment group was decreased significantly (P=0.002). (4) The incidence of aGVHD of the effective treatment group was 5/19 (26%) patients, all of which were I-II degree. The incidence of aGVHD of iron load group was 22/34 (65%) cases, with 16 cases of I-II degree, 6 cases of III-IV degree. The risk of aGVHD in the effective treatment group was significantly decreased (P=0.01). (5) The median disease-free survival（DFS）in effective treatment group was 28.9（0.3-89.5）and 21.2（0.1-81.0）months in iron load group during a median follow-up period of 22.0 (0.1-89.0) months.The DFS of effective treatment group was prolonged (P=0.053).
Conclusion
Effective iron chelating therapy before transplantation was helpful to hematopoietic reconstitution, and significantly reduced the incidence and degree of infection and aGVHD, decreased transplantation related mortality(TRM) and prolonged DFS, thereby improved the success rate of transplantation in MDS.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Iron chelation, Myelodysplasia
Type: Eposter Presentation
Background
Iron overload (IO) is general among patients with myelodysplastic syndrome (MDS). IO increased the non-relapse mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Therefore, the application of iron chelating therapy in allo-HSCT attracts the extensive attention recently. r severe HC following HSCT.
Aims
To investigate the effect of iron chelating therapy on hematopoietic reconstitution and related complications of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myelodysplastic syndrome (MDS).
Methods
Various clinical parameters were analyzed retrospectivly in 57 MDS patients with iron overload (IO)who received allogeneic transplantation. According to the level of serum ferritin (SF) before transplantation, we divided the patients into two groups: the effective treatment group (19 cases, SF<1000ng/ml) and iron overload group (38 cases, SF≥1000ng/ml).
Results
(1) 30/57 cases were received iron chelating treatment, 19/30 (63%) cases obtained obvious curative effect, the SF level before transplantation was<1000ng/ml, the median was 561(223-846) ng/ml. The effort of other 11/30 (37%) cases was not obvious, with the SF level before transplantation was ≥1000ng/ml,the median was 1262(1100-2352) ng/ml. 27/57 patients didn't received iron chelating therapy before transplantation, the SF level before transplantation was≥1000ng/ml,the median was 1540(1320-3112) ng/ml. (2) The rate of fully-engraftment in the effective treatment group and iron overload group was 19/19 (100%) and 34/38 (89%). And the latter group had 4/38 (11%) cases failed the hematopoietic reconstitution.The medium time of myeloid and platelet reconstitution of the 19 cases of effective treatment group was (12±2) and (16±6) days respectively, while those of 34 cases of iron overload group was (13±3) and (18±6) days. The hematopoietic reconstruction was shorten in the former group, however the difference between the two groups had no statistical significance (P=0.441, P=0.579). (3) The infection rate of the effective treatment group and iron overload group was 7/19 (37%) patients and 28/34 (82%) patients respectively. The risk of infection of the effective treatment group was decreased significantly (P=0.002). (4) The incidence of aGVHD of the effective treatment group was 5/19 (26%) patients, all of which were I-II degree. The incidence of aGVHD of iron load group was 22/34 (65%) cases, with 16 cases of I-II degree, 6 cases of III-IV degree. The risk of aGVHD in the effective treatment group was significantly decreased (P=0.01). (5) The median disease-free survival（DFS）in effective treatment group was 28.9（0.3-89.5）and 21.2（0.1-81.0）months in iron load group during a median follow-up period of 22.0 (0.1-89.0) months.The DFS of effective treatment group was prolonged (P=0.053).
Conclusion
Effective iron chelating therapy before transplantation was helpful to hematopoietic reconstitution, and significantly reduced the incidence and degree of infection and aGVHD, decreased transplantation related mortality(TRM) and prolonged DFS, thereby improved the success rate of transplantation in MDS.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Iron chelation, Myelodysplasia
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