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Serum hepcidin-25 level linked with high mortality in patients with non-Hodgkin lymphoma

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Abstract

Hepatic hepcidin-25 production is stimulated by systemic inflammation, and it interferes with the body’s utilization of iron, leading to anemia. A 1-year prospective study was conducted to elucidate an association of serum hepcidin-25 concentration with mortality in anemic patients with non-Hodgkin lymphoma (NHL). Serum hepcidin-25 levels were measured in 50 NHL patients using liquid chromatography-tandem mass spectrometry. The patients were stratified into a high- and a low-hepcidin-25 group according to the median of serum hepcidin-25 concentrations. Factors associated with hemoglobin (Hb) were determined by multivariate regression analysis, incorporating serum hepcidin-25 and inflammatory markers including ferritin and interleukin-6 (IL-6) as covariates. The association between serum hepcidin-25 and mortality was analyzed using both the Kaplan-Meier method and a multivariate proportional hazards regression model. The median of serum hepcidin-25 concentrations was 49.8 (0.6–269) ng/mL, a level approximately nine times greater than the reference value for healthy individuals. Hb level was significantly lower in the high than in the low-hepcidin-25 group. Serum hepcidin-25 was extracted as the significant factor associated with Hb, but neither ferritin nor IL-6 was. The cumulative mortality was significantly greater in the high than in the low-hepcidin-25 group (56.0 vs. 24.0 %; P = 0.0222). The mortality risk for the presence of high hepcidin-25 was four times greater (hazard ratio [95 % confidence interval]: 3.66 [1.12–16.4]). In conclusion, serum hepcidin-25 levels are elevated in anemic NHL patients, and in this study, the group with higher hepcidin-25 levels manifested advanced anemia and poor survival.

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Acknowledgments

We thank Dr. Yoshiharu Maeda in Department of Chemotherapy and Dr. Makoto Saito in Statistics Division in Komagome Hospital for their great contributions to this study.

Conflict of interest

The authors declare no conflicts of interest. The results presented in this paper have not been published previously in whole or part, except in abstract format.

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Authors and Affiliations

  1. Department IV of Internal Medicine, Tokyo Women’s Medical University, 8-1, Kawadacho, Shinjuku-Ku, Tokyo, 162-0054, Japan

    Masaki Hara, Minoru Ando, Ken Tsuchiya & Kosaku Nitta

  2. Renal Division, Department of Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-Ku, Tokyo, 113-0021, Japan

    Masaki Hara & Minoru Ando

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  1. Masaki Hara
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  2. Minoru Ando
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  3. Ken Tsuchiya
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  4. Kosaku Nitta
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Correspondence to Minoru Ando.

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Hara, M., Ando, M., Tsuchiya, K. et al. Serum hepcidin-25 level linked with high mortality in patients with non-Hodgkin lymphoma. Ann Hematol 94, 603–608 (2015). https://doi.org/10.1007/s00277-014-2255-1

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  • DOI: https://doi.org/10.1007/s00277-014-2255-1

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