Sequential evaluation of serum hepcidin in anemic myeloma patients: Study of correlations with myeloma treatment, disease variables, and anemia response

Katodritou, Eirini; Ganz, Tomas; Terpos, Evangelos; Verrou, Evgenia; Olbina, Gordana; Gastari, Vassiliki; Hadjiaggelidou, Christina; Varthaliti, Maria; Georgiadou, Sofia; Westerman, Mark; Zervas, Konstantinos

doi:10.1002/ajh.21448

Cited by 16 publications

(13 citation statements)

References 19 publications

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“…At time of diagnosis, 70% of our patients were anemic, which confirms Birgegards ( 13 ) data, 85.3%. Age of our anemic patient was 60, which is in agreement with previously reported data ( 14 ). 70 % of our patients were male patients, similar to Haraguchti’s study ( 15 ), 56% male patients, average age of 66 indicating that myeloma is disease occurring in older age mainly in men.…”

Section: Discussionsupporting

confidence: 93%

Dilemma: Correlation Between Serum Level of Hepcidin and IL-6 in Anemic Myeloma Patients

Ibricevic-Balic¹,

Ićindić-Nakas²,

Hasić³

et al. 2016

Med Arh

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Introduction:Anemia occurs in 60% to 80 % of patients with newly diagnosed myeloma multiplex (MM). The cause of anemia in MM is probably multi factorial and involved among the others hepcidin and some cytokines, especially interleukine-6. Anemia in MM is one of the risk factor used in Durie-Salmon classification for staging and prognostic score. Treatment options are set according to this score with most significant impact on survival.Aim:To estimate baseline level of serum hepcidin, IL-6 and iron metabolism markers in anemic MM patients, possible role of hepcidin and its interaction with IL-6.Methods:27 patients with newly diagnosed MM were enrolled in this observational, prospective study and age, gender matched 60 healthy controls. Erythrocyte count, hemoglobin, serum hepcidin, interleukin-6, iron, ferritin and transferrin were measured.Results:Anemia was diagnosed in 70% of MM patients. Serum hepcidin was significantly higher in MM group (55.5 ng/mL) than in control 5.9 ng/mL (p=0000). In myeloma patients serum IL-6 was 3.59 pg/mL, anemic 3.80 pg/mL, non-anemic 0.33 pg/mL, without significant difference. It was not found significant correlation between hepcidin and IL-6 in anemic myeloma patients.Conclusion:High level of hepcidin probably causes anemia in MM but its high expression is not due only to IL-6.

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Section: Discussionsupporting

confidence: 93%

Dilemma: Correlation Between Serum Level of Hepcidin and IL-6 in Anemic Myeloma Patients

Ibricevic-Balic¹,

Ićindić-Nakas²,

Hasić³

et al. 2016

Med Arh

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“…However, there were no significant changes in serum prohepcidin levels within a 22-h time frame in that study of healthy individuals (14). In MM patients with anemia, urinary, or serum hepcidin was positively correlated with serum ferritin and negatively with hemoglobin (19,28,29). By contrast, serum prohepcidin was not correlated with serum iron and ferritin in our subjects.…”

Section: Discussionmentioning

confidence: 96%

Serum prohepcidin levels are potential prognostic markers in patients with multiple myeloma

Haraguchi

Uto

Ohnou

et al. 2012

Experimental and Therapeutic Medicine

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Prohepcidin is the prohormone of hepcidin. Anemia is one of the main clinical features in patients with multiple myeloma (MM) and hepcidin may be associated with iron homeostasis in these patients. However, the clinical significance of prohepcidin is not fully understood. In this retrospective study, we measured serum prohepcidin levels using an immunoassay technique to study its clinical significance in 39 MM patients. Serum prohepcidin levels in patients with MM were weakly correlated with alkaline phosphatase (ALP) levels (r=0.32, P=0.048), calculated by Spearman’s rank correlation, but not with other clinical data, including hemoglobin, serum iron or ferritin. In addition, patients with severe renal insufficiency [creatinine clearance (CCr) <50 ml/min] had significantly higher prohepcidin levels compared with patients with mild or no renal insufficiency (CCr ≥50 ml/min, P=0.047). In contrast, low serum prohepcidin levels less than 110 ng/ml were an independent predictor of poor overall survival [hazard ratio (HR), 5.29; 95% confidence interval (CI), 1.65–17.03] in addition to serum creatinine levels of at least 2 mg/dl (HR, 5.32; CI, 1.10–25.64), serum calcium (HR, 3.53; CI, 1.01–12.33) and ECOG performance status grade 4 (HR, 4.15; CI, 1.32–13.09) in the multivariate analysis using Cox proportional hazards model. In the subset of 31 MM patients with CCr ≥50 ml/min, low serum prohepcidin (HR, 5.65; CI, 1.60–19.95) was an indicator of poor prognosis in multivariate analysis. These results indicate that serum prohepcidin levels may be associated with ALP and renal function but not iron homeostasis, in MM patients. In addition, lower serum prohepcidin levels are potential independent indicators of poor overall survival in MM patients regardless of renal function.

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“…35 Eighty % of patients treated with immunomodulatory agents (IMIDs) or conventional chemotherapy had a clinical response (at least 50% fall in M-protein) and their abnormally high pre-treatment hepcidin levels significantly fell during therapy. Importantly, the hepcidin levels at approximately 1 month after starting therapy predicted the improvement of anemia in response to therapy (p<0.05 for increase in hemoglobin concentration of at least 2 g/dl from baseline value after 8 weeks of therapy).…”

Section: Role Of Hepcidin and Dysregulated Iron Metabolism In Anementioning

confidence: 99%

Iron in Multiple Myeloma

VanderWall¹,

Daniels‐Wells²,

Penichet³

et al. 2013

Crit Rev Oncog

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Multiple myeloma is a non-curable B cell malignancy in which iron metabolism plays an important role. Patients with this disorder almost universally suffer from a clinically significant anemia, which is often symptomatic, and which is due to impaired iron utilization. Recent studies indicate that the proximal cause of dysregulated iron metabolism and anemia in these patients is cytokine-induced upregulation of hepcidin expression. Malignant myeloma cells are dependent on an increased influx of iron and therapeutic efforts are being made to target this requirement. The studies detailing the characteristics and biochemical abnormalities in iron metabolism causing anemia and the initial attempts to target iron therapeutically are described in this review.

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Sequential evaluation of serum hepcidin in anemic myeloma patients: Study of correlations with myeloma treatment, disease variables, and anemia response

Cited by 16 publications

References 19 publications

Dilemma: Correlation Between Serum Level of Hepcidin and IL-6 in Anemic Myeloma Patients

Dilemma: Correlation Between Serum Level of Hepcidin and IL-6 in Anemic Myeloma Patients

Serum prohepcidin levels are potential prognostic markers in patients with multiple myeloma

Iron in Multiple Myeloma

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