Iron chelation therapy improves hematopoiesis in patients with hematological malignancy after hematopoietic stem cell transplantation

Abstract

Objective To investigate the effect and safety of iron chelation therapy on hematopoiesis in hematological malignancy patients with iron overload after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods The clinical data of 38 hematological malignancy patients who suffered from iron overload after allo-HSCT and were treated in our hospital from May 2019 to June 2021 were retrospectively reviewed and analyzed. According to receiving iron chelation or not, they were divided into treatment group (n=21, oral administration of deferasirox) and control group (n=17, no iron chelation). The changes of hemoglobin (Hb) level, platelet (PLT) count, white blood cell (WBC) count and serum ferritin (SF) level were compared between the 2 groups, and the adverse reactions during administration were observed as well. Results At 2, 4 and 8 weeks after treatment, Hb level and PLT count in the treatment group were significantly improved from baseline as compared with the control group (P 0.05). SF levels in the treatment group was decreased from baseline at 4 and 8 weeks, significantly lower than those of the control group [-867 (-1 918~ 477) vs 436 (-408~467) μg/L, P < 0.001;-1 243 (-2 784~364) vs 541 (-674~578) μg/L, P < 0.001]. None of the patients in the treatment group developed serious gastrointestinal symptoms or severe damage to liver and kidney functions. Conclusion Iron chelation therapy can effectively improve the hematopoiesis, with satisfactory safety, in the patients suffering from iron overload after allo-HSCT.

Keywords

• allogeneic hematopoietic stem cell transplantation
• iron chelation therapy
• hematopoiesis