title: Highly Elevated Serum Hepcidin in Patients with Acute Myeloid Leukemia prior to and after Allogeneic Hematopoietic Cell Transplantation: Does This Protect from Excessive Parenchymal Iron Loading?
abstract: Hepcidin is upregulated by inflammation and iron. Inherited (HFE genotype) and treatment-related factors (blood units (BU), Iron overload) affecting hepcidin (measured by C-ELISA) were studied in 42 consecutive patients with AML prior to and after allogeneic hematopoietic cell transplantation (HCT). Results. Elevated serum ferritin pre- and post-HCT was present in all patients. Median hepcidin pre- and post-HCT of 358 and 398 ng/mL, respectively, were elevated compared to controls (median 52 ng/mL) (P < .0001). Liver and renal function, prior chemotherapies, and conditioning had no impact on hepcidin. Despite higher total BU after HCT compared to pretransplantation (P < .0005), pre- and posttransplant ferritin and hepcidin were similar. BU influenced ferritin (P = .001) and hepcidin (P = .001). No correlation of pre- or posttransplant hepcidin with pretransplant ferritin was found. HFE genotype did not influence hepcidin. Conclusions. Hepcidin is elevated in AML patients pre- and post-HCT due to transfusional iron-loading suggesting that hepcidin synthesis remains intact despite chemotherapy and HCT.
authors.affiliation: Department of Hematology/Oncology, University of Leipzig, Johannesallee 32a, 04103 Leipzig, Germany.
authors.forename: Ann-Kathrin
authors.initials: AK
authors.lastname: Eisfeld
authors.forename: Mark
authors.initials: M
authors.lastname: Westerman
authors.forename: Rainer
authors.initials: R
authors.lastname: Krahl
authors.forename: Sabine
authors.initials: S
authors.lastname: Leiblein
authors.forename: Uwe Gerd
authors.initials: UG
authors.lastname: Liebert
authors.forename: Marianne
authors.initials: M
authors.lastname: Hehme
authors.forename: Daniel
authors.initials: D
authors.lastname: Teupser
authors.forename: Dietger
authors.initials: D
authors.lastname: Niederwieser
authors.forename: Haifa Kathrin
authors.initials: HK
authors.lastname: Al-Ali