TY - JOUR
T1 - Non transferrin bound iron (NTBI) in acute leukemias throughout conventional intensive chemotherapy
T2 - Kinetics of its appearance and potential predictive role in infectious complications
AU - Belotti, Angelo
AU - Duca, Lorena
AU - Borin, Lorenza
AU - Realini, Silvia
AU - Renso, Rossella
AU - Parma, Matteo
AU - Pioltelli, Pietro
AU - Pogliani, Enrico
AU - Cappellini, Maria Domenica
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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. μM 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).
AB - 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. μM 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).
KW - Acute leukemia
KW - Chemotherapy
KW - Non transferrin bound iron
KW - NTBI
KW - Transfusional iron overload
UR - http://www.scopus.com/inward/record.url?scp=84920364574&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84920364574&partnerID=8YFLogxK
U2 - 10.1016/j.leukres.2014.11.003
DO - 10.1016/j.leukres.2014.11.003
M3 - Article
C2 - 25435028
AN - SCOPUS:84920364574
VL - 39
SP - 88
EP - 91
JO - Leukemia Research
JF - Leukemia Research
SN - 0145-2126
IS - 1
ER -