[The Effect of Serum Ferritin before Transplantation on Implantation in MDS and AML Patients after Unrelated Cord Blood Transplantation].

OBJECTIVE

To analyze the effect of high serum ferritin (SF) before transplantation on erythrocyte, granulocyte and platelet implantation in unrelated cord blood transplantation (UCBT) patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML).

METHODS

The medical records of 60 patients with MDS and AML who underwent UCBT in the First Affiliated Hospital of University of Science and Technology of China from January 2020 to December 2022 were retrospectively collected. According to the SF level before transplantation, they were divided into high SF group (SF≥1 000 μg/L, n=20) and non-high SF group (SF<1 000 μg/L, n=40). The red blood cell (RBC) infusion volume before transplantation, implantation time of RBC, granulocyte and platelet, implantation risk and prognosis were analyzed and compared between the two groups.

RESULTS

There was no correlation between the level of SF before transplantation and RBC infusion. After transplantation, the median implantation time of RBC in the high SF group was 28.5(14-149) d, which was longer than 21(10-83) d in the non-high SF group ( P < 0.05). The median time of granulocyte engraftment in the high SF group was 16.5(12-63) d, while that in the non-high SF group was 16(12-49) d, with no statistical difference between the two groups (P >0.05). The median platelet engraftment time in the high SF group was 45(12-206) d, while that in the non-high SF group was 35.5(14-149) d, with no statistical difference between the two groups (P >0.05). Kaplan-Meier cumulative implantation probability analysis showed that the rate of erythroid implantation in the non-high SF group was higher than that in the high SF group ( P < 0.05), while there was no significant difference in the rates of granulocyte and platelet implantation between the two groups (P >0.05). The 1-year overall survival rates of the non-high SF group and high SF group were 95% and 90%, respectively, with no statistical difference between the two groups (P >0.05).

CONCLUSION

SF levels before cord blood transplantation in MDS and AML patients have an impact on post transplant erythroid implantation. Detecting and intervening of iron load in patients before transplant may be beneficial for improving implantation and prognosis.