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Title: Clinical Significance of Serum Hepcidin Levels on Early Infectious Complications in Allogeneic Hematopoietic Stem Cell Transplantation
Authors: Kanda, Junya  kyouindb  KAKEN_id  orcid (unconfirmed)
Mizumoto, Chisaki
Kawabata, Hiroshi  KAKEN_id
Ichinohe, Tatsuo
Tsuchida, Hideyuki
Tomosugi, Naohisa
Matsuo, Keitaro
Yamashita, Kouhei  kyouindb  KAKEN_id
Kondo, Tadakazu  kyouindb  KAKEN_id  orcid (unconfirmed)
Ishikawa, Takayuki
Uchiyama, Takashi
Author's alias: 諫田, 淳也
Keywords: Allogeneic stem cell transplantation
Bacterial infection
Issue Date: Aug-2009
Publisher: Elsevier
Journal title: Biology of Blood and Marrow Transplantation
Volume: 15
Issue: 8
Start page: 956
End page: 962
Abstract: The association of iron overload with complications of allogeneic hematopoietic stem cell transplantation (HSCT) has been suggested in previous studies. Because hepcidin plays a central role in the regulation of iron homeostasis, we analyzed the association between pretransplant serum hepcidin-25 levels and early infectious complications after allogeneic HSCT. We studied 55 consecutive adult patients with a median age of 47 years (range: 20-64 years) who underwent allogeneic HSCT for hematologic malignancies at our institution. Thirty-two patients had myelogenous malignancies; the remaining 23 had lymphogenous malignancies. The median pretransplant serum hepcidin level of patients in the study was 21.6 ng/mL (range: 1.4-371 ng/mL), which was comparable to that of healthy volunteers (median: 19.1 ng/mL [range: 2.3-37 ng/mL]; n = 17). When cumulative incidences of documented bacterial and cytomegalovirus (CMV) infections at day 100 were compared according to pretransplant hepcidin-25 levels, the incidence of bacterial, but not CMV, infection, was significantly higher in the high-hepcidin group (?50 ng/mL; n = 17) than in the low-hepcidin group (<50 ng/mL; n = 38) (65% [95% confidence interval, 38%-82%] versus 11% [3%-23%]; P < .001). This finding was confirmed by multivariate Cox analysis adjusted for confounders, including pretransplant ferritin and C-reactive protein (CRP) levels. No fungal infection was documented in either group. These results suggest that the pretransplant serum hepcidin-25 level may be a useful marker for predicting the risk of early bacterial complications after allogeneic HSCT. Larger prospective studies are, however, warranted to confirm our findings.
Rights: c 2009 American Society for Blood and Marrow Transplantation.
This is not the published version. Please cite only the published version.
DOI(Published Version): 10.1016/j.bbmt.2009.04.008
PubMed ID: 19589485
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