Iron parameters, non-transferrin bound iron and hepcidin levels at diagnosis AND their importance for prognosis in multiple myeloma

Anemia of chronic disease occurs 60-80% of active untreated patients with multiple myeloma characterized with iron metabolism disorder.Hepcidin attaches ferroportin and decreases iron release from macrophages and enterocytes,hence the idea for its role in the development of anemia of chronic disease,especially being in a close relationship with inflammatory response,came into question.In addition to these factors,NTBI,an iron form occurring when transferrin?s binding capacity exceeds,is sought as an ultimate toxic molecule creating oxidative destruction, so there is a recent debut in these studies.We sought to evaluate the value at the time of diagnosis and prognosis of standard iron parameters,NTBI and hepcidin by using 40 untreated multiple myeloma patients in various stages and 29 healthy adults.Mean iron and TIBC levels were low(p=0,0001 and p<0,0001 respectively),ferritin and hepcidin levels were high(p=0,0001 and p<0,0001) compared to control group.When patients were grouped as Durie-Salmon Staging System only TIBC(p<0,05),grouped as ISS all parameters but iron had statistically significant difference between stages(hepcidin p<0,001;rest p<0,05). Although median NTBI values for patient and control groups were same,there was statistically significant difference(p<0,05). Consequently,there was no sign for patients being iron excess.Studying the correlation between iron parameters and biochemical parameters of staging showed correlation of iron with TIBC and ferritin with hepcidin at both patient and control groups and the most significant relation observed at hepcidin and ferritin at patient group.Of staging parameters,ß2-microglobulin determined to be the strongest parameter to show correlation with iron parameters.We propose that anemia stage is related with disease stage and prognosis of newly diagnosed multiple myeloma patients and using hepcidin,in addition to standard iron parameters,may be beneficial.