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Master thesis

Impact pronostique d'une surcharge en fer avant allogreffe de cellules souches hématopoïétiques

Abstract : Iron overload is a well-established adverse prognostic factor in patients who undergo hematopoietic stem-cell transplantation (HSCT) for thalassemia and appears to play a similar role in patients with acute leukemia andmyelodysplasic syndrome.Materials and methods : retrospective study about 224 consecutive patients (adults and children) whoundenvent HSCT in Nancy from june 1996 to january 2008 and assessment of pretransplant serum ferritinimpact on overall suivival (OS), even free survival (EFS), treatment-related mortality (TRM), complications(graft-versus-host disease GVHD, veino-occlusive disease VOD, infections) in uni (Kaplan Meier) andmultivaiiate (Cox) analysis.Results : Median pretransplant ferritin was 1334 nglml (range 13-13 157), 98 patients had ferritin level >1600nglml, witch was correlated with MRI liver iron concentration (p<10[exponent -4], r=0,68). Patients with ferritin level>1600nglml had a poorer outcome at 2-years (OS : p=0,009, EFS : p=0,015, TRM : p=0,05). On Cox multivanateregression analyses, grade 3 (p=0,002) and 4 (p<[exponent -5]) acute GVHD, no chronic GVHD (p=10[exponent -5]), cord blood stemce11 source (p<10[exponent -5]), CMV status (p=0,0004) were independant adverse prognostic factors for survival.Incidences of acute GVHD, hepatic GVHD, VOD and infections were similar, but average ferritin of the 34fungal infected patients was 2075 nglml versus 1682 for the others.Conclusion : These results do not correspond to published data. The studied population was too heterogeneous;a sub-group analysis would be interesting.
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Master thesis
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https://hal.univ-lorraine.fr/hal-01732576
Contributor : Colette Orange <>
Submitted on : Wednesday, March 14, 2018 - 3:07:43 PM
Last modification on : Friday, October 23, 2020 - 5:00:25 PM
Long-term archiving on: : Tuesday, September 4, 2018 - 2:21:25 PM

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  • HAL Id : hal-01732576, version 1

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Cécile Tomowiak. Impact pronostique d'une surcharge en fer avant allogreffe de cellules souches hématopoïétiques. Sciences du Vivant [q-bio]. 2008. ⟨hal-01732576⟩

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