High Ferritin Before Transplant Increases Cytopenia Post-transplant in HLA Mismatched Hematopoietic Stem Cell Transplantation in β-Thalassemia Major

Liao Jianyun; Issa Moussa Mardo; Wen Jianyun; Zhou Xiaohui; Peng Zhiyong; Liu Huaying; Chen Libai; He Yuelin; Pei Fuyu; Wu Xuedong; Feng Xiaoqin; Bai Jing; Su Qingxia; Li Chunfu

doi:doi:10.11648/j.ajp.20180402.13

High Ferritin Before Transplant Increases Cytopenia Post-transplant in HLA Mismatched Hematopoietic Stem Cell Transplantation in β-Thalassemia Major

Liao Jianyun, Issa Moussa Mardo, Wen Jianyun, Zhou Xiaohui, Peng Zhiyong, Liu Huaying, Chen Libai, He Yuelin, Pei Fuyu, Wu Xuedong, Feng Xiaoqin, Bai Jing, Su Qingxia, Li Chunfu

Published in American Journal of Pediatrics (Volume 4, Issue 2)

Received: 13 April 2018 Accepted: 24 May 2018 Published: 14 June 2018

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Abstract

The objective is to find out the causes of Cytopenia post-engraftment (CPE) in hematopoietic stem cell transplantation (HSCT) for patients with β-thalassemia major (β-TM). For this, 61 consecutive β-TM patients underwent 7/8 HLA matched HSCT from January 1, 2009 to June 30, 2015 were retrospectively analyzed. Thirty-eight patients suffered from CPE and the remainder (n=23) associated without CPE. The effect of pre-transplant ferritin (PTF) and recipient and donor age on CPE were analyzed in the two groups. The CPE was defined as white blood cell counts less than 3.0×109/L for four weeks or longer without infection of cytomegalovirus, human parvovirus B19 virus and Epstein-Barr virus. As result, in univariate analysis, PTF level was a high-risk factor for CPE and significant higher in CPE group than no-CPE group (3927.9 ± 1314.9 vs 2291.0 ± 994.4 ng/ml, p=0.000). The result was also proved by multi-factor binary regression analysis (p=0.001). The optimal value of PTF level by R language (R 2.15.2) is 2500ng/ml, which is cutoff value in the two groups. The current study showed high PTF level was a high-risk factor of CPE for β-TM patients underwent 7/8 HLA-matched HSCT. PTF should be reduced below 2500ng/L if the 7/8 matched HSCT must be done.

Published in	American Journal of Pediatrics (Volume 4, Issue 2)
DOI	10.11648/j.ajp.20180402.13
Page(s)	31-35
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Ferritin, Cytopenia, Thalassemia, HSCT

References

[1]	Rachmilewitz, E.A. and P.J. Giardina, How I treat thalassemia. Blood, 2011. 118(13): p. 3479-88.
[2]	Elborai, Y., A. Uwumugambi, and L. Lehmann, Hematopoietic stem cell transplantation for thalassemia. Immunotherapy, 2012. 4(9): p. 947-56.
[3]	Modell, B., et al., Improved survival of thalassaemia major in the UK and relation to T2* cardiovascular magnetic resonance. J Cardiovasc Magn Reson, 2008. 10: p. 42.
[4]	Ferrari, G., M. Cavazzana, and F. Mavilio, Gene Therapy Approaches to Hemoglobinopathies. Hematol Oncol Clin North Am, 2017. 31(5): p. 835-852.
[5]	Baronciani, D., et al., Hemopoietic stem cell transplantation in thalassemia: a report from the European Society for Blood and Bone Marrow Transplantation Hemoglobinopathy Registry, 2000-2010. Bone Marrow Transplant, 2016. 51(4): p. 536-41.
[6]	Gaziev, J., et al., Bone marrow transplantation for thalassemia from alternative related donors: improved outcomes with a new approach. Blood, 2013.
[7]	Jaing, T.H., et al., Unrelated cord blood transplantation for thalassaemia: a single-institution experience of 35 patients. Bone Marrow Transplant, 2012. 47(1): p. 33-9.
[8]	Bakhshi, S. and B. Biswas, Cytomegalovirus in hematological malignancies. Indian Pediatr, 2013. 50(2): p. 193-4.
[9]	Hsu, W.Y., et al., Successful management of multilineage autoimmune cytopenia complicated with severe infection and deep vein thrombosis in a patient with Hodgkin lymphoma post-autologous hematopoietic stem cell transplantation. Pediatr Transplant, 2016. 20(1): p. 168-71.
[10]	Waespe, N., U. Zeilhofer, and T. Gungor, Treatment-refractory multi-lineage autoimmune cytopenia after unrelated cord blood transplantation: remission after combined bortezomib and vincristine treatment. Pediatr Blood Cancer, 2014. 61(11): p. 2112-4.
[11]	Teachey, D.T. and M.P. Lambert, Diagnosis and management of autoimmune cytopenias in childhood. Pediatr Clin North Am, 2013. 60(6): p. 1489-511.
[12]	Li, C., et al., A novel conditioning regimen improves outcomes in beta-thalassemia major patients using unrelated donor peripheral blood stem cell transplantation. Blood, 2012. 120(19): p. 3875-81.
[13]	Altes, A., et al., Iron overload might increase transplant-related mortality in haematopoietic stem cell transplantation. Bone Marrow Transplant, 2002. 29(12): p. 987-9.
[14]	Holbro, A., M. Abinun, and T. Daikeler, Management of autoimmune diseases after haematopoietic stem cell transplantation. Br J Haematol, 2012. 157(3): p. 281-90.
[15]	Bhatt, V., et al., Autoimmune hemolysis and immune thrombocytopenic purpura after cord blood transplantation may be life-threatening and warrants early therapy with rituximab. Bone Marrow Transplant, 2016. 51(12): p. 1579-1583.
[16]	Thambiah, S.C., et al., Pre-transplantation serum ferritin as a prognostic marker in allogeneic haemopoietic stem cell transplant patients in a tertiary care hospital in Malaysia. Natl Med J India, 2016. 29(0970-258X (Print)): p. 136-140.
[17]	Shaw, B.E., et al., The impact of HLA genotyping on survival following unrelated donor haematopoietic stem cell transplantation. Br J Haemato, 2010. 150(1365-2141 (Electronic)): p. 251-8.
[18]	Oran, B., et al., Better allele-level matching improves transplant-related mortality after double cord blood transplantation. Haematologica, 2015. 100(10)(1592-8721 (Electronic)): p. 1361-70.
[19]	de Witte, T., The role of iron in patients after bone marrow transplantation. Blood Rev, 2008. 22(1532-1681 (Electronic)): p. 22-8.
[20]	Sucak, G.T., et al., Iron overload: predictor of adverse outcome in hematopoietic stem cell transplantation. Transplant Proc, 2010. 42 (5) (1873-2623 (Electronic)): p. 1841-8.
[21]	Kataoka, K., et al., Influence of pretransplantation serum ferritin on nonrelapse mortality after myeloablative and nonmyeloablative allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant, 2009. 15(2)(1523-6536 (Electronic)): p. 195-204.
[22]	Majhail, N.S., L.J. Lazarus Hm Fau - Burns, and L.J. Burns, Iron overload in hematopoietic cell transplantation. Bone Marrow Transplant, 2008 41(0268-3369 (Print)): p. 997-1003.
[23]	Pullarkat, V., et al., Iron overload adversely affects outcome of allogeneic hematopoietic cell transplantation. Bone Marrow Transplant, 2008. 42(12)(1476-5365 (Electronic)): p. 799-805.
[24]	Mahindra, A., et al., Elevated ferritin is associated with relapse after autologous hematopoietic stem cell transplantation for lymphoma. Biol Blood Marrow Transplant, 2008 14(1523-6536 (Electronic)): p. 1239-44.
[25]	Recalcati, S., et al., New functions for an iron storage protein: the role of ferritin in immunity and autoimmunity. J Autoimmun, 2008. 30(0896-8411 (Print)): p. 84-9.
[26]	Gray, C.P., P. Arosio P Fau - Hersey, and P. Hersey, Heavy chain ferritin activates regulatory T cells by induction of changes in dendritic cells. Blood, 2002. 99(9)(0006-4971 (Print)): p. 3326-34.
[27]	Sakamoto, S., et al., Differing impacts of pretransplant serum ferritin and C-reactive protein levels on the incidence of chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. Int J Hematol, 2013. 97(1865-3774 (Electronic)): p. 109-16.

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APA Style

Liao Jianyun, Issa Moussa Mardo, Wen Jianyun, Zhou Xiaohui, Peng Zhiyong, et al. (2018). High Ferritin Before Transplant Increases Cytopenia Post-transplant in HLA Mismatched Hematopoietic Stem Cell Transplantation in β-Thalassemia Major. American Journal of Pediatrics, 4(2), 31-35. https://doi.org/10.11648/j.ajp.20180402.13

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ACS Style

Liao Jianyun; Issa Moussa Mardo; Wen Jianyun; Zhou Xiaohui; Peng Zhiyong, et al. High Ferritin Before Transplant Increases Cytopenia Post-transplant in HLA Mismatched Hematopoietic Stem Cell Transplantation in β-Thalassemia Major. Am. J. Pediatr. 2018, 4(2), 31-35. doi: 10.11648/j.ajp.20180402.13

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AMA Style

Liao Jianyun, Issa Moussa Mardo, Wen Jianyun, Zhou Xiaohui, Peng Zhiyong, et al. High Ferritin Before Transplant Increases Cytopenia Post-transplant in HLA Mismatched Hematopoietic Stem Cell Transplantation in β-Thalassemia Major. Am J Pediatr. 2018;4(2):31-35. doi: 10.11648/j.ajp.20180402.13

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@article{10.11648/j.ajp.20180402.13,
  author = {Liao Jianyun and Issa Moussa Mardo and Wen Jianyun and Zhou Xiaohui and Peng Zhiyong and Liu Huaying and Chen Libai and He Yuelin and Pei Fuyu and Wu Xuedong and Feng Xiaoqin and Bai Jing and Su Qingxia and Li Chunfu},
  title = {High Ferritin Before Transplant Increases Cytopenia Post-transplant in HLA Mismatched Hematopoietic Stem Cell Transplantation in β-Thalassemia Major},
  journal = {American Journal of Pediatrics},
  volume = {4},
  number = {2},
  pages = {31-35},
  doi = {10.11648/j.ajp.20180402.13},
  url = {https://doi.org/10.11648/j.ajp.20180402.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20180402.13},
  abstract = {The objective is to find out the causes of Cytopenia post-engraftment (CPE) in hematopoietic stem cell transplantation (HSCT) for patients with β-thalassemia major (β-TM). For this, 61 consecutive β-TM patients underwent 7/8 HLA matched HSCT from January 1, 2009 to June 30, 2015 were retrospectively analyzed. Thirty-eight patients suffered from CPE and the remainder (n=23) associated without CPE. The effect of pre-transplant ferritin (PTF) and recipient and donor age on CPE were analyzed in the two groups. The CPE was defined as white blood cell counts less than 3.0×109/L for four weeks or longer without infection of cytomegalovirus, human parvovirus B19 virus and Epstein-Barr virus. As result, in univariate analysis, PTF level was a high-risk factor for CPE and significant higher in CPE group than no-CPE group (3927.9 ± 1314.9 vs 2291.0 ± 994.4 ng/ml, p=0.000). The result was also proved by multi-factor binary regression analysis (p=0.001). The optimal value of PTF level by R language (R 2.15.2) is 2500ng/ml, which is cutoff value in the two groups. The current study showed high PTF level was a high-risk factor of CPE for β-TM patients underwent 7/8 HLA-matched HSCT. PTF should be reduced below 2500ng/L if the 7/8 matched HSCT must be done.},
 year = {2018}
}

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TY  - JOUR
T1  - High Ferritin Before Transplant Increases Cytopenia Post-transplant in HLA Mismatched Hematopoietic Stem Cell Transplantation in β-Thalassemia Major
AU  - Liao Jianyun
AU  - Issa Moussa Mardo
AU  - Wen Jianyun
AU  - Zhou Xiaohui
AU  - Peng Zhiyong
AU  - Liu Huaying
AU  - Chen Libai
AU  - He Yuelin
AU  - Pei Fuyu
AU  - Wu Xuedong
AU  - Feng Xiaoqin
AU  - Bai Jing
AU  - Su Qingxia
AU  - Li Chunfu
Y1  - 2018/06/14
PY  - 2018
N1  - https://doi.org/10.11648/j.ajp.20180402.13
DO  - 10.11648/j.ajp.20180402.13
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 31
EP  - 35
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20180402.13
AB  - The objective is to find out the causes of Cytopenia post-engraftment (CPE) in hematopoietic stem cell transplantation (HSCT) for patients with β-thalassemia major (β-TM). For this, 61 consecutive β-TM patients underwent 7/8 HLA matched HSCT from January 1, 2009 to June 30, 2015 were retrospectively analyzed. Thirty-eight patients suffered from CPE and the remainder (n=23) associated without CPE. The effect of pre-transplant ferritin (PTF) and recipient and donor age on CPE were analyzed in the two groups. The CPE was defined as white blood cell counts less than 3.0×109/L for four weeks or longer without infection of cytomegalovirus, human parvovirus B19 virus and Epstein-Barr virus. As result, in univariate analysis, PTF level was a high-risk factor for CPE and significant higher in CPE group than no-CPE group (3927.9 ± 1314.9 vs 2291.0 ± 994.4 ng/ml, p=0.000). The result was also proved by multi-factor binary regression analysis (p=0.001). The optimal value of PTF level by R language (R 2.15.2) is 2500ng/ml, which is cutoff value in the two groups. The current study showed high PTF level was a high-risk factor of CPE for β-TM patients underwent 7/8 HLA-matched HSCT. PTF should be reduced below 2500ng/L if the 7/8 matched HSCT must be done.
VL  - 4
IS  - 2
ER  -

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Author Information

Liao Jianyun

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Issa Moussa Mardo

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Wen Jianyun

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Zhou Xiaohui

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Peng Zhiyong

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Liu Huaying

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Chen Libai

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
He Yuelin

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Pei Fuyu

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Wu Xuedong

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Feng Xiaoqin

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Bai Jing

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Su Qingxia

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Li Chunfu

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China

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APA Style

Liao Jianyun, Issa Moussa Mardo, Wen Jianyun, Zhou Xiaohui, Peng Zhiyong, et al. (2018). High Ferritin Before Transplant Increases Cytopenia Post-transplant in HLA Mismatched Hematopoietic Stem Cell Transplantation in β-Thalassemia Major. American Journal of Pediatrics, 4(2), 31-35. https://doi.org/10.11648/j.ajp.20180402.13

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ACS Style

Liao Jianyun; Issa Moussa Mardo; Wen Jianyun; Zhou Xiaohui; Peng Zhiyong, et al. High Ferritin Before Transplant Increases Cytopenia Post-transplant in HLA Mismatched Hematopoietic Stem Cell Transplantation in β-Thalassemia Major. Am. J. Pediatr. 2018, 4(2), 31-35. doi: 10.11648/j.ajp.20180402.13

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AMA Style

Liao Jianyun, Issa Moussa Mardo, Wen Jianyun, Zhou Xiaohui, Peng Zhiyong, et al. High Ferritin Before Transplant Increases Cytopenia Post-transplant in HLA Mismatched Hematopoietic Stem Cell Transplantation in β-Thalassemia Major. Am J Pediatr. 2018;4(2):31-35. doi: 10.11648/j.ajp.20180402.13

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@article{10.11648/j.ajp.20180402.13,
  author = {Liao Jianyun and Issa Moussa Mardo and Wen Jianyun and Zhou Xiaohui and Peng Zhiyong and Liu Huaying and Chen Libai and He Yuelin and Pei Fuyu and Wu Xuedong and Feng Xiaoqin and Bai Jing and Su Qingxia and Li Chunfu},
  title = {High Ferritin Before Transplant Increases Cytopenia Post-transplant in HLA Mismatched Hematopoietic Stem Cell Transplantation in β-Thalassemia Major},
  journal = {American Journal of Pediatrics},
  volume = {4},
  number = {2},
  pages = {31-35},
  doi = {10.11648/j.ajp.20180402.13},
  url = {https://doi.org/10.11648/j.ajp.20180402.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20180402.13},
  abstract = {The objective is to find out the causes of Cytopenia post-engraftment (CPE) in hematopoietic stem cell transplantation (HSCT) for patients with β-thalassemia major (β-TM). For this, 61 consecutive β-TM patients underwent 7/8 HLA matched HSCT from January 1, 2009 to June 30, 2015 were retrospectively analyzed. Thirty-eight patients suffered from CPE and the remainder (n=23) associated without CPE. The effect of pre-transplant ferritin (PTF) and recipient and donor age on CPE were analyzed in the two groups. The CPE was defined as white blood cell counts less than 3.0×109/L for four weeks or longer without infection of cytomegalovirus, human parvovirus B19 virus and Epstein-Barr virus. As result, in univariate analysis, PTF level was a high-risk factor for CPE and significant higher in CPE group than no-CPE group (3927.9 ± 1314.9 vs 2291.0 ± 994.4 ng/ml, p=0.000). The result was also proved by multi-factor binary regression analysis (p=0.001). The optimal value of PTF level by R language (R 2.15.2) is 2500ng/ml, which is cutoff value in the two groups. The current study showed high PTF level was a high-risk factor of CPE for β-TM patients underwent 7/8 HLA-matched HSCT. PTF should be reduced below 2500ng/L if the 7/8 matched HSCT must be done.},
 year = {2018}
}

Copy | Download

TY  - JOUR
T1  - High Ferritin Before Transplant Increases Cytopenia Post-transplant in HLA Mismatched Hematopoietic Stem Cell Transplantation in β-Thalassemia Major
AU  - Liao Jianyun
AU  - Issa Moussa Mardo
AU  - Wen Jianyun
AU  - Zhou Xiaohui
AU  - Peng Zhiyong
AU  - Liu Huaying
AU  - Chen Libai
AU  - He Yuelin
AU  - Pei Fuyu
AU  - Wu Xuedong
AU  - Feng Xiaoqin
AU  - Bai Jing
AU  - Su Qingxia
AU  - Li Chunfu
Y1  - 2018/06/14
PY  - 2018
N1  - https://doi.org/10.11648/j.ajp.20180402.13
DO  - 10.11648/j.ajp.20180402.13
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 31
EP  - 35
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20180402.13
AB  - The objective is to find out the causes of Cytopenia post-engraftment (CPE) in hematopoietic stem cell transplantation (HSCT) for patients with β-thalassemia major (β-TM). For this, 61 consecutive β-TM patients underwent 7/8 HLA matched HSCT from January 1, 2009 to June 30, 2015 were retrospectively analyzed. Thirty-eight patients suffered from CPE and the remainder (n=23) associated without CPE. The effect of pre-transplant ferritin (PTF) and recipient and donor age on CPE were analyzed in the two groups. The CPE was defined as white blood cell counts less than 3.0×109/L for four weeks or longer without infection of cytomegalovirus, human parvovirus B19 virus and Epstein-Barr virus. As result, in univariate analysis, PTF level was a high-risk factor for CPE and significant higher in CPE group than no-CPE group (3927.9 ± 1314.9 vs 2291.0 ± 994.4 ng/ml, p=0.000). The result was also proved by multi-factor binary regression analysis (p=0.001). The optimal value of PTF level by R language (R 2.15.2) is 2500ng/ml, which is cutoff value in the two groups. The current study showed high PTF level was a high-risk factor of CPE for β-TM patients underwent 7/8 HLA-matched HSCT. PTF should be reduced below 2500ng/L if the 7/8 matched HSCT must be done.
VL  - 4
IS  - 2
ER  -

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