Anemia in diffuse large B-cell non-Hodgkin lymphoma: the role of interleukin-6, hepcidin and erythropoietin. Issue 2 (February 2014)

• Record Type: Journal Article
• Authors: Tisi, Maria Chiara; Bozzoli, Valentina; Giachelia, Manuela; Massini, Giuseppina; Ricerca, Bianca Maria; Maiolo, Elena; D'Alo', Francesco; Larocca, Luigi Maria; Piciocchi, Alfonso; Tjalsma, Harold; Swinkels, Dorine W.; Voso, Maria Teresa; Leone, Giuseppe; Hohaus, Stefan
• Is Part Of: Leukemia & lymphoma. Volume 55:Issue 2(2014:Feb.)
• Page Start: 270
• Page End: 275
• Publication Date: 2014-02
• Subjects: Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.3109/10428194.2013.802314
• Languages: English
• ISSNs: 1042-8194

Abstract

<abstract> <title>Abstract</title> <p>Anemia is a frequent sign in patients with diffuse large B-cell lymphoma (DLBCL) at diagnosis. We determined erythropoietin, hepcidin and interleukin-6 (IL-6) in plasma samples of 53 patients with DLBCL. The majority of patients (40/53, 75%) showed defective endogenous erythropoietin production, in particular when anemia was present (<italic>p</italic> = 0.01). Hepcidin plasma levels were significantly higher in patients compared to controls (<italic>p</italic> = 0.006), particularly in those with characteristics associated with a more active disease, including elevated lactate dehydrogenase (LDH) (<italic>p</italic> = 0.0004), B-symptoms (<italic>p</italic> = 0.07) and an age-adjusted international prognostic index (IPI) score &gt; 1 (<italic>p</italic> = 0.01). Hepcidin levels correlated strongly to ferritin (<italic>r</italic> = 0.77, <italic>p</italic> &lt; 0.0001) and weakly to IL-6 concentrations (<italic>r</italic> = 0.30, <italic>p</italic> = 0.03), but not to hemoglobin values. IL-6 inversely correlated to hemoglobin values in both univariate and multivariate analysis (<italic>p</italic> = 0.04), including hepcidin and erythropoietin as variables. Our findings suggest that elevated hepcidin levels and inadequate erythropoietin response are frequent in DLBCL, but elevated IL-6 plays the major role for the development of anemia.</p> </abstract>