Anemia in diffuse large B-cell non-Hodgkin lymphoma: the role of interleukin-6, hepcidin and erythropoietin

Leuk Lymphoma. 2014 Feb;55(2):270-5. doi: 10.3109/10428194.2013.802314. Epub 2013 Jun 12.

Abstract

Anemia is a frequent sign in patients with diffuse large B-cell lymphoma (DLBCL) at diagnosis. We determined erythropoietin, hepcidin and interleukin-6 (IL-6) in plasma samples of 53 patients with DLBCL. The majority of patients (40/53, 75%) showed defective endogenous erythropoietin production, in particular when anemia was present (p = 0.01). Hepcidin plasma levels were significantly higher in patients compared to controls (p = 0.006), particularly in those with characteristics associated with a more active disease, including elevated lactate dehydrogenase (LDH) (p = 0.0004), B-symptoms (p = 0.07) and an age-adjusted international prognostic index (IPI) score > 1 (p = 0.01). Hepcidin levels correlated strongly to ferritin (r = 0.77, p < 0.0001) and weakly to IL-6 concentrations (r = 0.30, p = 0.03), but not to hemoglobin values. IL-6 inversely correlated to hemoglobin values in both univariate and multivariate analysis (p = 0.04), including hepcidin and erythropoietin as variables. Our findings suggest that elevated hepcidin levels and inadequate erythropoietin response are frequent in DLBCL, but elevated IL-6 plays the major role for the development of anemia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anemia / blood*
  • Anemia / complications
  • Erythropoietin / blood*
  • Female
  • Ferritins / blood
  • Hepcidins / blood*
  • Humans
  • Immunoenzyme Techniques / methods
  • Interleukin-6 / blood*
  • Logistic Models
  • Lymphoma, Large B-Cell, Diffuse / blood*
  • Lymphoma, Large B-Cell, Diffuse / complications
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Young Adult

Substances

  • Hepcidins
  • Interleukin-6
  • Erythropoietin
  • Ferritins