J Lab Med Qual Assur.  2013 Jun;35(1):1-7.

Serum Hepcidin Level as an Early Marker of Hematopoietic Activity after Allogeneic Peripheral Blood Stem Cell Transplantation

• Kim J
• Kwon KC
• Koo SH

Abstract

BACKGROUND
Hepcidin plays a central role in the regulation of iron metabolism, and hepatic iron production is stimulated by iron load and inflammation. Recent animal studies have shown that hepcidin levels increase when hematopoiesis is blocked. We aimed to monitor pre- and post-stem cell transplantation hepcidin levels and evaluate its association with hematologic recovery.
METHODS
The study group comprised 12 patients with hematologic malignancies (7 with AML, 4 with ALL, and 1 with refractory anemia with excess blasts-2) undergoing allogeneic peripheral blood stem cell transplantation (PBSCT). One day before and 3 days, 1 week, 2 weeks, 4 weeks, and 8 weeks after PBSCT, reticulocyte count and levels of Hb, ferritin, and C-reactive protein were monitored; serum hepcidin-25 was measured by ELISA.
RESULTS
The median serum hepcidin-25 levels (ng/mL) were significantly higher until 1 week after PBSCT (103.6, 103.3, and 96.5) than those at 2, 4, and 8 weeks after PBSCT (63.9, 53.9, and 56.6, respectively). The reticulocyte count also significantly increased from 2 weeks after PBSCT. The hepcidin level showed an inverse correlation with reticulocyte count (r=-0.56, P<0.001) and a weak positive correlation with ferritin (r=0.27, P=0.02). At 2 weeks, patients with high hepcidin levels (> or =63.9) tended to demonstrate lower Hb recovery at 8 weeks than patients with low hepcidin levels did (P=0.15), but without any differences in the incidence of complications.
CONCLUSIONS
These findings indicate that hepcidin production is associated with erythropoietic activity and that hepcidin level may be used as an early marker of hematopoietic recovery in PBSCT.

Keyword

Hepcidin; Peripheral blood; Stem cell transplantation; Hematopoiesis; Reticulocyte count

MeSH Terms

Anemia, Refractory
Animals
Antimicrobial Cationic Peptides
C-Reactive Protein
Cell Transplantation
Ferritins
Hematologic Neoplasms
Hematopoiesis
Humans
Incidence
Inflammation
Iron
Organothiophosphorus Compounds
Peripheral Blood Stem Cell Transplantation
Reticulocyte Count
Stem Cell Transplantation
Transplants
Antimicrobial Cationic Peptides
C-Reactive Protein
Ferritins
Iron
Organothiophosphorus Compounds