Inflammatory functional iron deficiency common in myelofibrosis, contributes to anaemia and impairs quality of life. From the Nordic MPN study Group. (1st January 2019)

• Record Type: Journal Article
• Authors: Birgegard, Gunnar; Samuelsson, Jan; Ahlstrand, Erik; Ejerblad, Elisabeth; Enevold, Christian; Ghanima, Waleed; Hasselbalch, Hans; Nielsen, Claus H.; Knutsen, Håvar; Pedersen, Ole B.; Sørensen, Anders; Andreasson, Björn
• Is Part Of: European journal of haematology. Volume 102:Number 3(2019)
• Page Start: 235
• Page End: 240
• Publication Date: 2019-01-01
• Subjects: anaemia of inflammation -- cytokines -- functional iron deficiency -- Myelofibrosis; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Blood -- Periodicals; 616.15005
• DOI: 10.1111/ejh.13198
• Languages: English
• ISSNs: 0902-4441

Abstract

Abstract: Objectives: The study investigates the hypothesis that inflammation in myelofibrosis (MF) like in myeloma and lymphoma, may disturb iron distribution and contribute to anaemia. Methods: A cross‐sectional study of 80 MF and 23 ET patients was performed. Results: About 35% of anaemic MF patients had functional iron deficiency (FID) with transferrin saturation <20 and normal or elevated S‐ferritin (<500 µg/L). In ET, FID was rare. In MF patients with FID, 70.6% were anaemic, vs 29.4% in patients without FID ( P = 0.03). Hepcidin was significantly higher in MF patients with anaemia, including transfusion‐dependent patients, 50.6 vs 24.4 µg/L ( P = 0.01). There was a significant negative correlation between Hb and inflammatory markers in all MF patients: IL‐2, IL‐6 and TNF‐α, ( P < 0.01‐0.03), LD ( P = 0.004) and hepcidin ( P = 0.03). These correlations were also seen in the subgroup of anaemic MF patients (Table3 ). Tsat correlated negatively with CRP ( P < 0.001). Symptom burden was heavier in MF patients with FID, and MPN‐SAF quality of life scores correlated with IL‐6 and CRP. Conclusions: The inflammatory state of MF disturbs iron turnover, FID is common and contributes to anaemia development and impairment of QoL. Anaemic MF patients should be screened for FID.