SERUM FERRITIN and SERUM HEPCIDIN LEVELS as PREDICTORS of EARLY POST HEMATOPOIETIC STEM CELL TRANSPLANTATION (<100D) INFECTIONS

Abstract

This study was conducted to correlate the pre transplant levels of serum ferritin and serum hepcidin with the incidence of early infectious complications and overall survival in first 100 days after transplantation. The study group included 25 patients undergoing bone marrow transplantation, recruited from bone marrow transplantation units and 30 healthy controls of matched age and gender. Median levels of serum ferritin and serum hepcidin were found to be higher in patients with all infections, those with bacterial infections when compared to those without infection, however these findings were statistically insignificant (p value = 0.97 for ferritin & 1.00 for hepcidin). Incidence of bacterial infection was highest in the pre engraftment period. Regarding overall survival, 17 patients surviving in the first 100 days, 8 patients dead, of dead patients 5 died from septicaemia, 2 died from veno-occlussive disease and 1 from acute GVHD. We also found that hepcidin specificity was better than ferritin specificity in predicting survival in first 100 days after transplant. We concluded that pretransplant high level of serum ferritin and serum hepcidin are probably related to increased incidence of bacterial infections (in first100 days after transplant). Also it affected survival in first 100 days after transplant. We recommend that pretransplant assaying serum hepcidin levels would be included as a part of the routine pretransplant work up, administeration of iron chelators as treatment of iron overload pretransplant and conducting more studies with larger scales to confirm our findings.