Serum Hepcidin Levels in Multiple Myeloma.

Background: Multiple myeloma (MM) is a malignant disease with a 10% frequency among all haematology neoplasms. It is characterized by clone proliferation of plasmatic cells in bone marrow, monoclonal gammopathy, and anemia, hypercalcemia, and kidney failure and bone lesions. IL-6 is an inflammatory cytokine, potential growth factor for myeloma cells, as elevated serum levels are connected with poor disease prognosis. IL-6 modulates many gene transcriptions, encoding synthesis of acute phase proteins, including C-reactive protein (CRP) and hepcidin.

Methods: We evaluated 21 patients newly diagnosed with multiple myeloma at the Department of Haematology at "Aleksandrovska" Hospital; average age 51 ± 5.2. Their results were compared to 21 age matched controls. Included patients were enrolled before treatment onset. In the included groups, we measured CBC, serum iron and total iron binding capacity, ferritin, soluble transferrin receptors, IL-6, and hepcidin.

Results: We established elevated serum hepcidin levels in MM patients compared to the control group: 99.4 ± 10.5 µg/L to 19.9 ± 2.8 µg/L (p < 0.001). Serum IL-6 and CRP concentrations were elevated in MM cases compared to controls (p < 0.005). In patients with MM we found strong negative correlation between serum hepcidin and inflammation markers, IL-6 and CRP. IL-6 shows r = -0.894, and CRP - r = -0.916; p < 0.001. Soluble transferrin receptors correlate negatively to hepcidin: r = -0.831, p < 0.001. Transferrin concentration correlated highly positive to hepcidin: r = 0.580; p < 0.001.

Conclusions: Our results show an important role of hepcidin in the evaluation of iron homeostasis disorders. Quantification of the peptide's concentration shows increased concentration in multiple myeloma patients. Treatment of anemia associated with multiple myeloma is still a serious challenge for clinicians.