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
em En
| WPRIM
| ID: wpr-143930
Biblioteca responsável:
WPRO
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.
Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Transplante Autólogo
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Triazóis
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Benzoatos
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Transfusão de Sangue
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Protocolos de Quimioterapia Combinada Antineoplásica
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Quelantes de Ferro
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Estudos Retrospectivos
/
Fatores de Risco
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Seguimentos
/
Antígenos CD34
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
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Child, preschool
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Humans
/
Infant
Idioma:
En
Revista:
Journal of Korean Medical Science
Ano de publicação:
2012
Tipo de documento:
Article