SWART, L. de, C. REINIERS, T. BAGGULEY, T. van MARREWIJK, D. BOWEN, E. HELLSTROM-LINDBERG, A. TATIC, A. SYMEONIDIS, G. HULS, J. CERMAK, A. A. van de LOOSDRECHT, H. GARELIUS, D. CULLIGAN, M. MACHETA, M. SPANOUDAKIS, P. PANAGIOTIDIS, Marta KREJČÍ, N. BLIJLEVENS, S. LANGEMEIJER, J. DROSTE, D. W. SWINKELS, A. de SMITH and T. de WITTE. Labile plasma iron levels predict survival in patients with lower-risk myelodysplastic syndromes. Haematologica. PAVIA: FERRATA STORTI FOUNDATION, 2018, vol. 103, No 1, p. 69-79. ISSN 0390-6078. Available from: https://dx.doi.org/10.3324/haematol.2017.171884.
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Basic information
Original name Labile plasma iron levels predict survival in patients with lower-risk myelodysplastic syndromes
Authors SWART, L. de (528 Netherlands), C. REINIERS (528 Netherlands), T. BAGGULEY (826 United Kingdom of Great Britain and Northern Ireland), T. van MARREWIJK (528 Netherlands), D. BOWEN (826 United Kingdom of Great Britain and Northern Ireland), E. HELLSTROM-LINDBERG (752 Sweden), A. TATIC (642 Romania), A. SYMEONIDIS (300 Greece), G. HULS (528 Netherlands), J. CERMAK (203 Czech Republic), A. A. van de LOOSDRECHT (528 Netherlands), H. GARELIUS (752 Sweden), D. CULLIGAN (826 United Kingdom of Great Britain and Northern Ireland), M. MACHETA (826 United Kingdom of Great Britain and Northern Ireland), M. SPANOUDAKIS (826 United Kingdom of Great Britain and Northern Ireland), P. PANAGIOTIDIS (826 United Kingdom of Great Britain and Northern Ireland), Marta KREJČÍ (203 Czech Republic, belonging to the institution), N. BLIJLEVENS (528 Netherlands), S. LANGEMEIJER (528 Netherlands), J. DROSTE (528 Netherlands), D. W. SWINKELS (528 Netherlands), A. de SMITH (528 Netherlands) and T. de WITTE (528 Netherlands, guarantor).
Edition Haematologica, PAVIA, FERRATA STORTI FOUNDATION, 2018, 0390-6078.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30205 Hematology
Country of publisher Italy
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 7.570
RIV identification code RIV/00216224:14110/18:00106196
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.3324/haematol.2017.171884
UT WoS 000418944500021
Keywords in English myelodysplastic syndromes
Tags 14110212, rivok
Tags International impact, Reviewed
Changed by Changed by: Soňa Böhmová, učo 232884. Changed: 14/2/2019 15:07.
Abstract
Red blood cell transfusions remain one of the cornerstones in supportive care of lower-risk patients with myelodysplastic syndromes. We hypothesized that patients develop oxidant-mediated tissue injury through the formation of toxic iron species, caused either by red blood cell transfusions or by ineffective erythropoiesis. We analyzed serum samples from 100 lower-risk patients with myelodysplastic syndromes at six-month intervals for transferrin saturation, hepcidin-25, growth differentiation factor 15, soluble transferrin receptor, non-transferrin bound iron and labile plasma iron in order to evaluate temporal changes in iron metabolism and the presence of potentially toxic iron species and their impact on survival. Hepcidin levels were low in 34 patients with ringed sideroblasts compared to 66 patients without. Increases of hepcidin and non-transferrin bound iron levels were visible early in follow-up of all transfusion-dependent patient groups. Hepcidin levels significantly decreased over time in transfusion-independent patients with ringed sideroblasts. Increased soluble transferrin receptor levels in transfusion-independent patients with ringed sideroblasts confirmed the presence of ineffective erythropoiesis and suppression of hepcidin production in these patients. Detectable labile plasma iron levels in combination with high transferrin saturation levels occurred almost exclusively in patients with ringed sideroblasts and all transfusion-dependent patient groups. Detectable labile plasma iron levels in transfusion-dependent patients without ringed sideroblasts were associated with decreased survival. In conclusion, toxic iron species occurred in all transfusion-dependent patients and in transfusion-independent patients with ringed sideroblasts. Labile plasma iron appeared to be a clinically relevant measure for potential iron toxicity and a prognostic factor for survival in transfusion-dependent patients.
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