Prevalence and risk factors of iron overload after hematopoietic stem cell transplantation for childhood acute leukemia: a LEA study.
Bone Marrow Transplant
; 52(1): 80-87, 2017 Jan.
Article
en En
| MEDLINE
| ID: mdl-27595286
ABSTRACT
Data on post-transplant iron overload (IO) are scarce in pediatrics. We conducted a prospective multicenter cohort study (Leucémie de l'Enfant et de l'Adolescent cohort) to determine the prevalence and risk factors of IO in 384 acute leukemia survivors transplanted during childhood. Prevalence of IO (ferritin level ⩾350 ng/mL) was 42.2% (95%CI 37.2-47.2%). Factors significantly associated with IO were 1) in univariate analysis:
older age at transplant (P<0.001), allogeneic versus autologous transplantation (P<0.001), radiation-based preparative regimen (P=0.035) and recent period of transplantation (P<0.001); 2) in multivariateanalysis:
older age at transplant in quartiles (Odds Ratio (OR)=7.64, 95% CI 3.73-15.64 for age >12.7 years and OR=5.36, 95% CI 2.63-10.95 for age from 8.2 to 12.7 years compared to age < 4.7 years), acute myeloid leukemia (OR=3.23, 95% CI 1.47-7.13), allogeneic graft (OR=4.34, 95% CI 2.07-9.12 for alternative donors and OR=2.53, 95% CI 1.2-5.33 for siblings, compared to autologous graft) and radiation-based conditioning regimen (OR=2.45, 95% CI 1.09-5.53). Graft-versus-host disease was an additional risk factor for allogeneic graft recipients. In conclusion, IO is a frequent complication in pediatric long-term survivors after transplantation for acute leukemia, more frequently observed in older children, those transplanted from alternative donors or with graft-versus-host disease.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Leucemia Mieloide Aguda
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Trasplante de Células Madre Hematopoyéticas
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Sobrecarga de Hierro
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Acondicionamiento Pretrasplante
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Leucemia-Linfoma Linfoblástico de Células Precursoras
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Ferritinas
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Supervivientes de Cáncer
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Child
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Female
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Humans
/
Male
Idioma:
En
Revista:
Bone Marrow Transplant
Asunto de la revista:
TRANSPLANTE
Año:
2017
Tipo del documento:
Article
País de afiliación:
Francia