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Inflammatory functional iron deficiency common in myelofibrosis, contributes to anaemia and impairs quality of life. From the Nordic MPN study Group

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  • Gunnar Birgegard
  • Jan Samuelsson
  • Erik Ahlstrand
  • Elisabeth Ejerblad
  • Christian Enevold
  • Waleed Ghanima
  • Hans Hasselbalch
  • Claus H Nielsen
  • Håvar Knutsen
  • Ole B Pedersen
  • Anders Sørensen
  • Björn Andreasson
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OBJECTIVES: The study investigates the hypothesis that inflammation in myelofibrosis (MF) like in myeloma and lymphoma, may disturb iron distribution and contribute to anaemia.

METHODS: A cross-sectional study of 80 MF and 23 ET patients was performed.

RESULTS: About 35% of anaemic MF patients had functional iron deficiency (FID) with transferrin saturation <20 and normal or elevated S-ferritin (<500 µg/L). In ET, FID was rare. In MF patients with FID, 70.6% were anaemic, vs 29.4% in patients without FID (P = 0.03). Hepcidin was significantly higher in MF patients with anaemia, including transfusion-dependent patients, 50.6 vs 24.4 µg/L (P = 0.01). There was a significant negative correlation between Hb and inflammatory markers in all MF patients: IL-2, IL-6 and TNF-α, (P < 0.01-0.03), LD (P = 0.004) and hepcidin (P = 0.03). These correlations were also seen in the subgroup of anaemic MF patients (Table ). Tsat correlated negatively with CRP (P < 0.001). Symptom burden was heavier in MF patients with FID, and MPN-SAF quality of life scores correlated with IL-6 and CRP.

CONCLUSIONS: The inflammatory state of MF disturbs iron turnover, FID is common and contributes to anaemia development and impairment of QoL. Anaemic MF patients should be screened for FID.

Original languageEnglish
JournalEuropean Journal of Haematology
Volume102
Issue number3
Pages (from-to)235-240
Number of pages6
ISSN0902-4441
DOIs
Publication statusPublished - Mar 2019

    Research areas

  • Anemia, Iron-Deficiency/diagnosis, Biomarkers, Blood Chemical Analysis, Bone Marrow/pathology, Cross-Sectional Studies, Cytokines/blood, Ferritins/blood, Humans, Inflammation/complications, Inflammation Mediators, Iron/blood, Primary Myelofibrosis/complications, Quality of Life

ID: 58906115