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Updated: Jun 28, 2026
Ferritinophagy: Assessing the Selective Degradation of Iron by Autophagy in Human Fibroblasts
Published on: February 23, 2024
Elevated ferritin is associated with relapse after autologous hematopoietic stem cell transplantation for lymphoma
Anuj Mahindra1, Brian Bolwell, Ronald Sobecks
1Department of Hematologic Oncology and Blood Disorders, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA. mahinda@ccf.org
Elevated serum ferritin is associated with reduced survival following allogeneic transplantation and an increased risk of toxic and infectious complications after autologous hematopoietic stem cell transplantation (ASCT). We studied 315 patients who underwent ASCT for Hodgkin (HL) or non-Hodgkin lymphoma (NHL) at our institution in whom pretransplantation ferritin was available to determine its association with survival. On multivariate analysis, a pretransplantation ferritin>685 ng/mL was associated with significantly lower overall (OS; P=.002) and relapse-free survival (RFS; P=.021). Ferritin>685 ng/mL was associated with a higher incidence of relapse (P=.005) and relapse mortality (P<.001), but not of nonrelapse mortality (NRM; P=.23). Similar results were seen when pretransplantation ferritin was analyzed as a continuous variable and by quartiles. Our results indicate the need for studies designed to correlate an elevated ferritin with iron overload and to analyze the benefit of strategies to reduce the extent of iron overload.
Elevated serum ferritin is associated with reduced survival following allogeneic transplantation and an increased risk of toxic and infectious complications after autologous hematopoietic stem cell transplantation (ASCT). We studied 315 patients who underwent ASCT for Hodgkin (HL) or non-Hodgkin lymphoma (NHL) at our institution in whom pretransplantation ferritin was available to determine its association with survival. On multivariate analysis, a pretransplantation ferritin>685 ng/mL was associated with significantly lower overall (OS; P=.002) and relapse-free survival (RFS; P=.021). Ferritin>685 ng/mL was associated with a higher incidence of relapse (P=.005) and relapse mortality (P<.001), but not of nonrelapse mortality (NRM; P=.23). Similar results were seen when pretransplantation ferritin was analyzed as a continuous variable and by quartiles. Our results indicate the need for studies designed to correlate an elevated ferritin with iron overload and to analyze the benefit of strategies to reduce the extent of iron overload.
