Multipl miyelom hastalarında hepsidin, solubl transferrin reseptörü ve büyüme farklılaşma faktörü-15’in anemiyle ilişkisi

Abstract

Amaç: Multipl myelom (MM) malign bir hematolojik hastalıktır ve hastaların çoğunluğunda anemi görülmektedir. Hepsidin, büyüme farklılaşma faktörü-15 (GDF-15), solubl transferrin reseptörü (sTfR) başta kronik hastalıklar ve kanserlerde olmak üzere birçok anemide çalışılmıştır ancak MM’daki anemide rollerini araştıran çalışmalar çok azdır. Multipl myelom hastalarında hepsidin, sTfR ve GDF-15 düzeylerini ve bu düzeylerin anemi parametreleri, hastalık evresi ve toplam sağkalım gibi klinik özelliklerle ilişkisini belirlemeyi amaçladık. Metod: Yeni tanı almış MM hastalarında ve sağlıklı gönüllülerde hepsidin, sTfR ve GDF-15 düzeylerinin yanı sıra diğer klinik ve anemi ile ilişkili parametreler analiz edildi. Bulgular: Miyelom hastaları kontrol grubuna göre belirgin düşük Hb ve Hct düzeylerine sahip olmalarına rağmen, GDF-15, hepsidin ve sTfR düzeylerinin hiçbiri gruplar arasında anlamlı bir farklılık göstermiyordu. MM hastaları içinde anemik alt grupta, anemik olmayan altgruba göre belirgin düşük hepsidin düzeyleri olduğunu saptadık. GDF-15, hepsidin ve sTfR düzeylerinin birbirleriyle zayıf ya orta düzeyde pozitif yönde korelasyon gösterirken, GDF15 kreatinin ile pozitif yönde köreleydi ve sTfR düzeyleri ise LDH, CRP, ferritin, albümin, kreatinin, Hb ve ISS evresi gibi birçok parametre ile ancak zayıf düzeyde korelasyon gösteriyordu. GDF-15, hepsidin ve sTfR düzeylerinin hiçbiri sağkalım üzerine anlamlı etkiye sahip değildi. Sonuç: Bu mediyatörlerinin MM anemisinde bir rolü olabileceğini ancak kronik hastalık anemisindeki gibi net bir ilişki olmadığını, hasta gruplarının özelliklerine göre değişken mekanizmalar olabileceğini düşündürmüştür.

Keywords

• Multipl miyelom
• anemi
• hepsidin
• büyüme farklılaşma faktörü-15
• soluble transferrin reseptörü
• sTfR

The Relationship of Hepcidin, Soluble Transferrin Receptor, Growth Differentiation Factor-15 And Anemia in Multipl Myeloma

Abstract

Objective: Multiple myeloma (MM) is a malignant hematological disease and anemia is observed in the majority of patients. Hepcidin, Growth differentiation factor-15 (GDF-15), soluble transferrin receptor (sTfR) have been investigated in many forms of anemia, especially in chronic diseases and cancers. However, there are few studies investigating their role in MM. We aimed to determine the relationship between hepcidin, sTfR and GDF-15 levels in MM patients and their clinical features such as anemia parameters, disease stage and overall survival. Method: Hepcidin, sTfR and GDF-15 levels, as well as clinical and anemia-related parameters, were analyzed in newly diagnosed MM patients and healthy volunteers. Result: Although MM patients had significantly lower Hb and Hct levels compared to the control group, none of the GDF-15, hepcidin and sTfR levels showed a significant difference between the groups. Among MM patients, we found that the anemic subgroup had significantly lower hepcidin levels than the non-anemic subgroup. GDF-15, hepcidin and sTfR levels showed weak or moderate positive correlation with each other, while GDF15 was positively correlated with creatinine and sTfR levels were correlated with many parameters such as LDH, CRP, ferritin, albumin, creatinine, Hb and ISS, all of which weak. None of the levels of GDF-15, hepcidin and sTfR had a significant effect on survival. Conclusion: We suggested that these mediators may play a role in anemia of MM but there is not a clear relashionship as in chronic disease anemia, there may be different mechanisms according to the characteristics of the patient groups.

Keywords

• Multipl myeloma
• anemia
• hepcidin
• Growth differentiation factor-15
• soluble transferrin receptor
• sTfR
• GDF-15

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