Serum Hepcidin Level in Patients with Acute Lymphoblastic Leukemia (ALL) during The Treatment Phase: Their Effects on Erythropoisis Activity and Iron Reserves

Abstract

Hepcidin levels increased significantly with increased of iron stores in early phase of acute leukemia patients when erithropoisis pressed by blast cells in bone marrow, then decreased significantly with acute leukemia remission. The study aimed to determine role of hepcidin in activity of erythropoisis and serum iron reserves in acute lymphoblastic leukemia (ALL) patients during phase of therapy. This study used an observational analytic design. Serum hepcidin examination used ELISA methods. Erythropoisis activity was determined by complete blood and reticulocyte percentage. Iron reserves was determined by serum iron and ferritin levels by ECLIA. Result shows a total of 48 patient subjects were divided into groups of induction, consolidation and maintenance phase with an average age of 6.81 years (induction), 9.7 years (consolidation) and 7.8 years (maintenance). In the normality test with Shapiro-Wilk data showed abnormal distribution (p <0.05). Analysis by the Kruskal-Wallis test showed there were differences between the three treatment phases in the examination of hemoglobin, reticulocytes, serum iron, ferritin and hepcidin (p <0.05). In statistical analysis with Spearman's rank correlation shows there is a significant correlation between hemoglobin with ferritin (r = -0.416, p = 0.003), hemoglobin with hepcidin (r = -0.305, p = 0.035), reticulocytes with hepcidin (r = -0.496), p = 0.000) and serum iron with hepcidin (r = -0.302, p = 0.037). We concluded that the higher levels of hepcidin indicate lower levels of hemoglobin, reticulocytes and serum iron in patients with acute lymphoblastic leukemia during treatment phase.

Hepcidin in Children and Adults with Acute Leukemia or Undergoing Hematopoietic Cell Transplantation: A Systematic Review

“…One hundred forty-seven articles underwent full-text review, and one hundred thirty-four were excluded. The remaining thirteen met all inclusion criteria [20][21][22]24,[31][32][33][34][35][36][37][38][39]. There was no disagreement about any of the studies selected for final inclusion in the systematic review.…”

“…The characteristics of the studies included in the review are given in Table 1 for casecontrol studies and in Table 2 for cohort and cross-sectional studies. The studies were published between 2008 and 2021 with 92% (n = 12) of the studies published on or before 2020 [20,22,24,[31][32][33][34][35][36][37][38][39]. Out of the thirteen studies [20][21][22]24,[31][32][33][34][35][36][37][38][39], three were conducted in Japan [22,24,31], two in Germany [32,38], two in China [20,34], and one each in the United States [33], Brazil [35], Egypt [36], Turkey [37], Indonesia [39], and Poland [21].…”

“…Out of the thirteen studies [20][21][22]24,[31][32][33][34][35][36][37][38][39], three were conducted in Japan [22,24,31], two in Germany [32,38], two in China [20,34], and one each in the United States [33], Brazil [35], Egypt [36], Turkey [37], Indonesia [39], and Poland [21]. Eleven studies were single-center [20,22,24,[31][32][33][34][35][36][37]39] while two were multicenter [21,38]. We included seven case-control studies [20,21,31,32,34,36,37], four cohort studies [22,24,35,…”

“…Eleven studies were single-center [20,22,24,[31][32][33][34][35][36][37]39] while two were multicenter [21,38]. We included seven case-control studies [20,21,31,32,34,36,37], four cohort studies [22,24,35,38] and two cross-sectional studies [33,39]. Eleven studies were fully published journal articles [20][21][22]24,[32][33][34][36][37][38][39]; one study was published as a brief report [31], and one as a letter to the editor [35].…”

“…The studies were published between 2008 and 2021 with 92% (n = 12) of the studies published on or before 2020 [20,22,24,[31][32][33][34][35][36][37][38][39]. Out of the thirteen studies [20][21][22]24,[31][32][33][34][35][36][37][38][39], three were conducted in Japan [22,24,31], two in Germany [32,38], two in China [20,34], and one each in the United States [33], Brazil [35], Egypt [36], Turkey [37], Indonesia [39], and Poland [21]. Eleven studies were single-center [20,22,24,[31][32][33][34][35][36][37]39] while two were multicent...…”