title: Clinical significance of serum hepcidin levels on early infectious complications in allogeneic hematopoietic stem cell transplantation.
abstract: The association of iron overload with complications of allogeneic hematopoietic stem cell transplantation (HSCT) has been suggested in previous studies. Because hepcidin plays a central role in the regulation of iron homeostasis, we analyzed the association between pretransplant serum hepcidin-25 levels and early infectious complications after allogeneic HSCT. We studied 55 consecutive adult patients with a median age of 47 years (range: 20-64 years) who underwent allogeneic HSCT for hematologic malignancies at our institution. Thirty-two patients had myelogenous malignancies; the remaining 23 had lymphogenous malignancies. The median pretransplant serum hepcidin level of patients in the study was 21.6 ng/mL (range: 1.4-371 ng/mL), which was comparable to that of healthy volunteers (median: 19.1 ng/mL [range: 2.3-37 ng/mL]; n = 17). When cumulative incidences of documented bacterial and cytomegalovirus (CMV) infections at day 100 were compared according to pretransplant hepcidin-25 levels, the incidence of bacterial, but not CMV, infection, was significantly higher in the high-hepcidin group (> or = 50 ng/mL; n = 17) than in the low-hepcidin group (<50 ng/mL; n = 38) (65% [95% confidence interval, 38%-82%] versus 11% [3%-23%]; P < .001). This finding was confirmed by multivariate Cox analysis adjusted for confounders, including pretransplant ferritin and C-reactive protein (CRP) levels. No fungal infection was documented in either group. These results suggest that the pretransplant serum hepcidin-25 level may be a useful marker for predicting the risk of early bacterial complications after allogeneic HSCT. Larger prospective studies are, however, warranted to confirm our findings.
authors: Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. jkanda16@kuhp.kyoto-u.ac.jp
authors: Junya
authors: J
authors: Kanda
authors: Chisaki
authors: C
authors: Mizumoto
authors: Hiroshi
authors: H
authors: Kawabata
authors: Tatsuo
authors: T
authors: Ichinohe
authors: Hideyuki
authors: H
authors: Tsuchida
authors: Naohisa
authors: N
authors: Tomosugi
authors: Keitaro
authors: K
authors: Matsuo
authors: Kouhei
authors: K
authors: Yamashita
authors: Tadakazu
authors: T
authors: Kondo
authors: Takayuki
authors: T
authors: Ishikawa
authors: Takashi
authors: T
authors: Uchiyama
mesh_terms: D000328:Adult; D023181:Antimicrobial Cationic Peptides / Q000097:blood*; D001424:Bacterial Infections / Q000175:diagnosis / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000209:etiology; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D064451:Hepcidins; D006801:Humans; D019190:Iron Overload / Q000150:complications; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis / Q000209:etiology*; D011237:Predictive Value of Tests; D012306:Risk; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; C578702:HAMP protein, human; D064451:Hepcidins