| ironjustice@aol.com 2006-10-09, 4:29 pm |
| Iron overload can mimic graft-versus-host disease exacerbation
Hepatitis Weekly via NewsEdge Corporation :.
2006 JUL 10 - (NewsRx.com) -- Iron overload can mimic graft-versus-host
disease exacerbation.
According to a recent report published in the journal Biology of Blood
and Marrow Transplantation , "Iron overload presenting as exacerbation
of hepatic graft-versus-host disease (GVHD) after allogeneic
hematopoietic stem cell transplantation has not been previously
described.
"We report 6 patients with established hepatic GVHD in whom iron
overload (median serum ferritin, 7231 mc g/dL; median transferrin
saturation, 77%) resulting from a lifetime median of 20 units of packed
red blood cell transfusions was manifested by worsening of liver
function.".
"Liver biopsies performed in 4 patients confirmed severe iron overload
and also hepatic GVHD. Analysis for the C282Y and H63D hemochromatosis
gene mutation was negative for the homozygous state in all 6 patients.
"Erythropoietin-assisted phlebotomy resulted in normalization of liver
function at a median of 7 months and of serum ferritin at a median of
11 months, reported R.T. Kamble and colleagues at the university of
Oklahoma.
"Immunosuppressive therapy was successfully tapered in all 4 patients
who completed the phlebotomy program, and this supported the impression
that iron overload, rather than GVHD, was the principal cause of liver
dysfunction.
"At a median follow-up of 50 months (range, 18-76 months) from the
transplantation and 25 months (range, 5-36 months) from ferritin
normalization," continued investigators, "all 4 patients require
maintenance phlebotomy.".
The authors concluded, "We conclude that iron overload can mimic GVHD
exacerbation, thus resulting in unnecessary continuation or
intensification of immunosuppressive therapy for GVHD, and that
maintenance phlebotomy is necessary after successful iron-reduction
therapy.".
Kamble and colleagues published their study in Biology of Blood and
Marrow Transplantation (Iron overload manifesting as apparent
exacerbation of hepatic graft-versus-host disease after allogeneic
hematopoietic stem cell transplantation. Biol Blood Marrow Transplant,
2006;12(5):506-510).
For additional information, contact R.T. Kamble, university of
Oklahoma, Health Science Center, 920 SL Young Blvd., WP-2080, Oklahoma
City, OK 73190, USA.
The publisher's contact information for the journal Biology of Blood
and Marrow Transplantation is: Carden Jennings Publ Co. Ltd., Blake
Center, Ste. 200, 1224 W Main St., Charlottesville, VA 22903, USA.
Keywords: Oklahoma City, Oklahoma, United States, Erythropoietin,
Graft-Versus-Host Disease, Hemochromatosis, Iron Overload,
Iron-Reduction Therapy.
This article was prepared by Hepatitis Weekly editors from staff and
other reports. Copyright 2006, Hepatitis Weekly via NewsRx.com.
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