Secondary hemochromatosis as a long-term complication of the treatment of hematologic malignancies

The increased cure rate of hematologic malignancies including the use of bo ne marrow transplantation has focused attention on the chronic toxicity and quality of life of the survivors. We have observed five patients who have been diagnosed with clinically significant iron overload, presumably due to packed red blood cell transfusions, greater than or equal to 12 months aft er transplant for a hematologic malignancy. In these patients, there is no history of veno-occlusive disease or family history of hemochromatosis. The allotransplant patient has been free of chronic graft versus host disease. Family screening has been negative. No patient developed clinically signif icant endocrinopathy, arthropathy, or cardiac disease. The patients have be en treated with phlebotomy to bring the transferrin saturation and ferritin levels to normal. The long-term follow-up of patients treated for a hemato logic malignancy should include analysis of hepatitis C virus and iron stat us. This may prevent the development of clinically significant chronic live r disease and possibly malignancy. (C) 1999 Wiley-Liss, Inc.