[Regulatory mechanisms of iron metabolism in patients with acute leukemia].

Aim: To estimate the levels of hepsidine, HIF-1alpha, erythropoietin, other proteins of iron metabolism; to characterize dysregulation of metabolic processes in leukogenesis.

Material And Methods: Thirty eight patients with newly diagnosed acute leukemia (AL) were divided into three groups by anemia severity: group 1 (Hb > 90 g/l), group 2 (Hb 90-70 g/l), group 3 (Hb < 70 g/l). Erythropoietin concentration was measured with enzyme immunoassay, serum ferritin (SF)--by radioimmunoassay; HIF-1alpha, hepsidine--by sandvich enzyme immunoassay with use of monospecific antisera and monoclonal antibodies against relevant antigens.

Results: In AL patients SF before treatment was 10 times higher than in healthy subjects, administration of cytostatics elevated this concentration even more. Hepsidine and HIF-1alpha are also elevated. Treatment reduces hepsidine level twice in all the groups. This may be due to reduction of the tumor mass. Erythropoietin was 20-35 times higher in all the patients, especially in myelotoxic agranulocytosis (up to 1000 mU/ml) with reduction after recovery of hemopoiesis (in some patients to normal values 20-30 mU/ml). Hepsidine and HIF-1alpha concentrations were also maximal in myelotoxic agranulocytosis (20-28 pg/ml). After recovery of hemopoiesis these values fell to initial values 7-9 pg/ ml). Transfusion of donor erythrocytic mass normalized HIF-1alpha concentration and decreased that of hepsidine. Its elevation and high HIF-1alpha were observed after the transfusion in 17% patients.

Conclusion: Disorders in regulatory mechanisms in AL patients throughout the observation confirm the role of the proteins studied in homeostasis. Changes in HIF-1alpha and hepsidine concentrations can be used as indicators of transfusion efficacy.