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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
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Department of Hematology, University Hospital Linköping, Linköping, Sweden.
Örebro University Hospital. Örebro University, School of Medical Sciences.ORCID iD: 0000-0003-1928-7518
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
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2019 (English)In: European Journal of Haematology, ISSN 0902-4441, E-ISSN 1600-0609, Vol. 102, no 3, p. 235-240Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Munksgaard Forlag, 2019. Vol. 102, no 3, p. 235-240
Keywords [en]
Myelofibrosis, anaemia of inflammation, cytokines, functional iron deficiency
National Category
Hematology
Identifiers
URN: urn:nbn:se:oru:diva-82848DOI: 10.1111/ejh.13198ISI: 000458535100005PubMedID: 30472746Scopus ID: 2-s2.0-85059327899OAI: oai:DiVA.org:oru-82848DiVA, id: diva2:1437643
Available from: 2020-06-09 Created: 2020-06-09 Last updated: 2021-04-27Bibliographically approved

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