Rust and corrosion in hematopoietic stem cell transplantation: the problem of iron and oxidative stress

摘要: Iron overload is a common acute and long-term event associated with autologous allogeneic hematopoietic stem cell transplantation (HSCT). In state of iron excess, free becomes available to catalyze the conversion reactive oxygen species (ROS) intermediates such as superoxide anion (O2*-) hydrogen peroxide (H2O2) highly toxic radicals hydroxyl radical (OH*). ROS may help promote chronic liver disease, sinusoidal obstruction syndrome, idiopathic pneumonia syndrome bacterial, fungal other opportunistic infections. Phlebotomy has been effectively safely used deplete excess stores post-HSCT in thalassemic iron-overloaded patients. Intracellular levels also be decreased through pharmacologic chelating agents, while antioxidants N-acetylcysteine, glutamine (glutathione precursor) captopril have shown replenish glutathione redox potential scavenge radicals. A better understanding mechanisms involved iron-generated pro-oxidant HSCT will likely lead reduced toxicity improved patient outcomes.