Serum levels of soluble transferrin receptor correlate with severity of disease but not with iron stores in patients with malignant lymphomas.

Soluble transferrin receptor levels in serum (s-sTfR) may be useful in differentiating between iron deficiency anemia and anemia of chronic disease. However, there is both theoretical and clinical evidence for elevated s-sTfR levels in patients with various hematological malignancies. In the present study, routine bone marrow aspirations were performed in 82 patients with malignant lymphomas (63 with non-Hodgkin's lymphoma and 19 with Hodgkin's disease). Smears were stained for evaluation of iron stores and graded. Patients were also given a disease score based on bone marrow morphology, erythrocyte sedimentation rate and LDH. s-sTfR levels correlated better with disease score [partial Spearman rank correlation coefficient (r(s)) controlled for iron stores was 0.51 (95% confidence interval 0.39-0.65); p < 0.001] than with iron stores [partial r(s) controlled for disease score was -0.25 (95% confidence interval -0.44 to -0.03); p = 0.027]. This study showed elevated s-sTfR levels in patients with malignant lymphomas without any signs of iron deficiency anemia. The diagnosis of iron deficiency anemia should not be established upon the basis of s-sTfR alone in this group of patients.