Background: Transfusion-dependency affects the natural history of myelodysplastic syndromes. Secondary iron overload may concur to this effect. The relative impact of these factors on the outcome of patients with myelodysplastic syndrome receiving allogeneic stem-cell transplantation remains to be clarified.
Design And Methods: We retrospectively evaluated the prognostic effect of transfusion history and iron overload on the post-transplantation outcome of 357 patients with myelodysplastic syndrome reported to the Gruppo Italiano Trapianto di Midollo Osseo (GITMO) registry between 1997 and 2007.
Results: Transfusion-dependency was independently associated with reduced overall survival (hazard ratio=1.48, P=0.017) and increased non-relapse mortality (hazard ratio=1.68, P=0.024). The impact of transfusion-dependency was noted only in patients receiving myeloablative conditioning (overall survival: hazard ratio=1.76, P=0.003; non-relapse mortality: hazard ratio=1.70, P=0.02). There was an inverse relationship between transfusion burden and overall survival after transplantation (P=0.022); the outcome was significantly worse in subjects receiving more than 20 red cell units. In multivariate analysis, transfusion-dependency was found to be a risk factor for acute graft-versus-host disease (P=0.04). Among transfusion-dependent patients undergoing myeloablative allogeneic stem cell transplantation, pre-transplantation serum ferritin level had a significant effect on overall survival (P=0.01) and non-relapse mortality (P=0.03). This effect was maintained after adjusting for transfusion burden and duration, suggesting that the negative effect of transfusion history on outcome might be determined at least in part by iron overload.
Conclusions: Pre-transplantation transfusion history and serum ferritin have significant prognostic value in patients with myelodysplastic syndrome undergoing myeloablative allogeneic stem cell transplantation, inducing a significant increase of non-relapse mortality. These results indicate that transfusion history should be considered in transplantation decision-making in patients with myelodysplastic syndrome.
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http://dx.doi.org/10.3324/haematol.2009.011429 | DOI Listing |
Indian J Clin Biochem
January 2025
ICMR-National Institute of Research in Tribal Health, Jabalpur, 482003 India.
Sickle cell disease (SCD) and thalassemia are the most common hereditary disorders encountered in Central India. Timely identification of these disorders is critical to reduction in severe clinical manifestations and for identifying disease burden. Present study reports spectrum of hemoglobinopathies among the referred anemia patients to single centre in central India.
View Article and Find Full Text PDFCureus
December 2024
General Practice, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BRA.
Felty's syndrome (FS) is a rare and complex condition most commonly seen as a complication of longstanding rheumatoid arthritis (RA), characterized by a triad of RA, splenomegaly, and neutropenia. Diagnosing FS can be challenging due to its diverse clinical presentations and overlap with other hematologic and autoimmune conditions. We report a 47-year-old male with a history of severe anemia, recurrent blood transfusions, and a chronic leg ulcer.
View Article and Find Full Text PDFHepatitis B virus (HBV) remains a critical public health issue in low- and middle-income countries (LMICs), particularly among pregnant women in Nigeria. Routine screening using rapid diagnostic kits is common in antenatal care, yet the accuracy of these tests can vary. This study aimed to determine the seroprevalencwe of HBV among pregnant women who had previously undergone screening using rapid diagnostic kits at Obafemi Awolowo Teaching Hospital, Ilesa, Osun State, Nigeria, to assess the effectiveness of initial screening and identify any missed cases.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
January 2025
Baylor College of Medicine Houston TX, United States.
Objective: Monochorionic diamniotic (MCDA) twins with amniotic fluid abnormalities that do not meet criteria for twin-twin transfusion syndrome (TTTS) concern physicians and families. This study aimed to describe the natural history of amniotic fluid abnormalities.
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Biomed Res Int
January 2025
Department of Biology, College of Natural & Computational Sciences, University of Gondar, Gondar, Ethiopia.
Hepatitis and human immunodeficiency virus (HIV) are major public health issues in developing countries, including Ethiopia. These viruses can be transmitted from mother to child during birth or through contact with contaminated blood. In many areas of Ethiopia, viral hepatitis and HIV infections are significant health concerns for pregnant women.
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