NONTRANSFERRIN-BOUND IRON IN SERUM OF PATIENTS RECEIVING BONE-MARROW TRANSPLANTS

Nontransferrin-bound iron (NTBI) and other parameters of iron status w ere measured in 40 patients undergoing bone marrow transplantation (BM T) prior to conditioning therapy (between day -10 and -7), at the time of BMT (day 0), and 2 weeks later (day + 14). Serum iron and transfer rin saturation values were normal before conditioning therapy. At day 0 serum iron values were high and median transferrin saturation was 98 % (changes in the values of both serum iron and transferrin saturation , p < .0001). Transferrin saturation values were still elevated 2 week s posttransplant (day + 14 vs. baseline values, p = .0001). Starting a t low NTBI levels pretransplant (median 0.4 mu mol/l, range 0-4.2 mu m ol/l, controls: less than or equal to 0.4 mu mol/l), all patients reve aled high levels on day 0 (median 4.0 mu mol/l, range 1.9-6.9 mu mol/l , p < .0001) and 2 weeks posttransplant (median 2.7 mu mol/l, range 0- 6.2 mu mol/l, p < .0001). These observations indicate that the plasma iron pool in patients undergoing BMT increases to a level at which the normal ability to sequestrate iron becomes exhausted and considerable amounts of NTBI appear in serum. This ''free'' form of iron can media te the production of reactive oxygen species and may cause organ toxic ity in the early posttransplantation period. (C) 1997 Elsevier Science Inc.