Iron overload manifesting as apparent exacerbation of hepatic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
R KambleJames N George

Abstract

Iron overload presenting as exacerbation of hepatic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation has not been previously described. We report 6 patients with established hepatic GVHD in whom iron overload (median serum ferritin, 7231 mug/dL; median transferrin saturation, 77%) resulting from a lifetime median of 20 units of packed red blood cell transfusions was manifested by worsening of liver function. Liver biopsies performed in 4 patients confirmed severe iron overload and also hepatic GVHD. Analysis for the C282Y and H63D hemochromatosis gene mutation was negative for the homozygous state in all 6 patients. Erythropoietin-assisted phlebotomy resulted in normalization of liver function at a median of 7 months and of serum ferritin at a median of 11 months. Immunosuppressive therapy was successfully tapered in all 4 patients who completed the phlebotomy program, and this supported the impression that iron overload, rather than GVHD, was the principal cause of liver dysfunction. At a median follow-up of 50 months (range, 18-76 months) from the transplantation and 25 months (range, 5-36 months) from ferritin normalization, all 4 patients require maintenance phlebotomy. We conclude t...Continue Reading

References

Jan 1, 1985·Clinical and Laboratory Haematology·R E Marcus, E R Huehns
Feb 5, 1981·The New England Journal of Medicine·A I SchaferH F Bunn
Mar 1, 1997·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·H L BonkovskyA L Rothman
Aug 26, 1998·Bone Marrow Transplantation·S I StrasserG B McDonald
Mar 4, 2000·The American Journal of the Medical Sciences·J C Barton, L F Bertoli
Nov 13, 2001·British Journal of Haematology·J B Porter
Nov 25, 2003·Hematology·Ernest BeutlerJames D Cook

❮ Previous
Next ❯

Citations

Jan 5, 2014·Virchows Archiv : an International Journal of Pathology·Judith StiftUNKNOWN Liver Pathology Group of the German-Austrian-Swiss Working Group on GvHD
Oct 16, 2014·Transplantation Reviews·J P Norvell
Sep 28, 2010·Advances in Hematology·Vinod Pullarkat
Oct 30, 2009·Leukemia & Lymphoma·H Joachim DeegHoward M Shulman
Nov 15, 2011·Expert Review of Hematology·Katja SockelUwe Platzbecker
Feb 17, 2011·Expert Review of Hematology·Junya KandaNelson J Chao
Jan 10, 2012·Seminars in Hematology·Eolia BrissotMohamad Mohty
Jul 14, 2010·Transplantation Proceedings·G T SucakM Yağci
Oct 23, 2015·Journal of Clinical and Experimental Hematopathology : JCEH·Hiroaki TanakaChiaki Nakaseko
Oct 1, 2015·Journal of Pediatric Hematology/oncology·Ashley SchemppAngela R Smith
May 28, 2008·Best Practice & Research. Clinical Haematology·Paul A Carpenter
Jul 10, 2007·Journal of the American College of Surgeons·Ralph G DePalmaLeo R Zacharski
Jun 4, 2008·Pediatric Transplantation·Thirachit ChotsampancharoenWing Leung
Oct 27, 2006·Pediatric Blood & Cancer·Héctor Melín-AldanaDavid A Jacobsohn
Sep 17, 2011·American Journal of Hematology·Ayalew Tefferi
Apr 8, 2010·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·George B McDonald
Sep 10, 2011·Hematology·Sahika Zeynep AkıGülsan Türköz Sucak
Apr 26, 2012·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Kit Man WongVikas Gupta
Feb 3, 2015·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Howard M ShulmanDavid E Kleiner
Jan 19, 2010·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Navneet S MajhailLinda J Burns
Jan 27, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Keisuke KataokaMineo Kurokawa
Jun 11, 2008·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Navneet S MajhailLinda J Burns
Jul 22, 2008·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Anna GayaEmili Montserrat
Sep 22, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Alessandro BuscaAntonio Piga
Nov 23, 2013·Journal of Korean Medical Science·Jun Ho JangUNKNOWN Korean Society of Hematology Aplastic Anemia Working Party
Jun 2, 2016·American Journal of Clinical Pathology·Marcela SalomaoAntonia Sepulveda
Apr 29, 2008·Bone Marrow Transplantation·N S MajhailL J Burns
Sep 3, 2008·Bone Marrow Transplantation·V PullarkatS J Forman
Mar 7, 2006·Bone Marrow Transplantation·R Kamble, M Mims
Jun 29, 2016·Romanian Journal of Internal Medicine = Revue Roumaine De Médecine Interne·R-G Mihăilă
Nov 21, 2018·Ophthalmic Genetics·Nancy Hernández-MartínezCristina Villanueva-Mendoza
Oct 10, 2020·International Journal of Hematology·Tahereh RostamiAmir Ali Hamidieh
Nov 23, 2019·Blood Reviews·Eolia BrissotMarie-Bérengère Troadec

❮ Previous
Next ❯

Related Concepts

Related Feeds

Allogenic & Autologous Therapies

Allogenic therapies are generated in large batches from unrelated donor tissues such as bone marrow. In contrast, autologous therapies are manufactures as a single lot from the patient being treated. Here is the latest research on allogenic and autologous therapies.

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.