High pretransplant hepcidin levels are associated with poor overall survival and delayed platelet engraftment after allogeneic hematopoietic stem cell transplantation. (1st December 2016)

• Record Type: Journal Article
• Authors: Sakamoto, Soichiro; Kawabata, Hiroshi; Kanda, Junya; Uchiyama, Tatsuki; Mizumoto, Chisaki; Kitano, Toshiyuki; Kondo, Tadakazu; Hishizawa, Masakatsu; Tomosugi, Naohisa; Takaori‐Kondo, Akifumi
• Is Part Of: Cancer medicine. Volume 6:Number 1(2017:Jan.)
• Page Start: 120
• Page End: 128
• Publication Date: 2016-12-01
• Subjects: Allogeneic hematopoietic stem cell transplantation -- engraftment -- hepcidin -- iron; 616.994005
• DOI: 10.1002/cam4.974
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: Iron overload is considered a risk factor for mortality in patients with hematopoietic malignancies. Hepcidin is a key regulator of systemic iron balance. We previously reported dynamic changes of serum hepcidin‐25 levels in patients with hematologic malignancies after allogeneic hematopoietic stem cell transplantation (allo‐HSCT). In this study, we retrospectively analyzed the association of pretransplant hepcidin‐25 levels with overall survival (OS), engraftment, and other clinical outcomes of allo‐HSCT in patients with hematologic malignancies. A total of 166 patients were divided into two groups depending on their pretransplant serum hepcidin‐25 levels; their median age was 49.5 years, and the median follow‐up time was 46.8 months. At 3 years, the patients in the high‐hepcidin group had a significantly lower OS than those in the low‐hepcidin group (49.2 vs. 69.0%, respectively; P = 0.006). Multivariate analysis revealed that pretransplant serum hepcidin‐25 level, sex, and disease status were independently associated with OS. The incidence of platelet engraftment was significantly lower in the high‐hepcidin group than in the low‐hepcidin group, whereas no significant differences were observed in neutrophil and reticulocyte engraftments between these groups. Hence, pretransplant serum hepcidin levels can be a marker for predicting delayed platelet recovery after allo‐HSCT. Abstract : We previously showed that patients with hematologic malignancies exhibit dynamic changes in levels of hepcidin‐25, which is the key regulator of systemic iron, during allogeneic haematopoietic stem cell transplantation. In this study, we investigated the association of pre‐transplant serum hepcidin‐25 levels with overall survival, and found that the patients with high levels of pre‐transplant hepcidin‐25 had significantly lower overall survival than patients with low‐hepcidin‐25. Moreover, the incidence of platelet engraftment was significantly lower in patients with high pre‐transplant hepcidin‐25.