Non transferrin bound iron (NTBI) in acute leukemias throughout conventional intensive chemotherapy: Kinetics of its appearance and potential predictive role in infectious complications

被引：18

作者：

Belotti, Angelo ^{[1
]}

Duca, Lorena ^{[2
]}

Borin, Lorenza ^{[1
]}

Realini, Silvia ^{[1
]}

Renso, Rossella ^{[1
]}

Parma, Matteo ^{[1
]}

Pioltelli, Pietro ^{[1
]}

Pogliani, Enrico ^{[1
]}

Cappellini, Maria Domenica ^{[2
]}

机构：

[1] Univ Milano Bicocca, Osped San Gerardo, Dept Hematol, I-20900 Monza, Italy

[2] Univ Milan, Ca Granda Fdn IRCCS, Dept Med & Med Specialities, I-20122 Milan, Italy

来源：

LEUKEMIA RESEARCH | 2015年 / 39卷 / 01期

关键词：

NTBI; Non transferrin bound iron; Acute leukemia; Transfusional iron overload; Chemotherapy; ACUTE MYELOID-LEUKEMIA; THERAPY; DISEASE;

D O I：

10.1016/j.leukres.2014.11.003

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

We analyzed appearance of non transferrin bound iron (NTBI) in 30 transplant eligible patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) during conventional chemotherapy treatment program and evaluated possible relationship with transfusional body iron intake, iron parameters and clinical complications. For each course, serum samples for NTBI detection were taken prior to chemotherapy, during treatment and during subsequent bone marrow myelosuppression: NTBI was assessed by HPLC. Appearance of NTBI was observed from the start of induction treatment and was still detectable during bone marrow myelosuppression; the recovery of the bone marrow function coincided with the disappearance of NTBI. This kinetic was observed in all subsequent high doses chemotherapy courses, independently from confounding variables such as transfusional iron intake and transferrin saturation. NTBI seems to be a consequence of chemotherapy induced lysis of bone marrow cells and, partly, of hepatocytes after cytotoxic injury. The subsequent persistence of NTBI throughout bone marrow myelosuppression is related to the transient suspension of erythropoietic activity. Moreover, NTBI levels >2 mu M at the beginning of iatrogenic myelosuppression were associated with higher risk of sepsis caused by Gram negative Bacilli (RR 2.571), also compared with other infectious complications (RR 1.954). (C) 2014 Elsevier Ltd. All rights reserved.

引用

页码：88 / 91

页数：4