Clinical Significance Of Detection Of Iron Metabolism Indexes In Patients With Hematological Malignant Disease

Objective:To explore the changes and clinical significance of iron metabolism indexes such as serum ferritin(sFn),serum transferritin(sTf),serum transferritin receptor(sTfR) in patients with hematological malignant disease before and after chemotherapy.Methods:33 patients with hematological malignant disease(including lymphoma, leukemia,multiple myeloma,myelodysplastic syndrome) were enrolled in the study in the hematology department of second affiliated hospital,Zhejiang University,college of medicine.We measured the CBC,bone marrow routine and iron bound of bone marrow cells,serumβ₂-microglobulin(β₂-MG),Lactate Dehydrogenase(LDH) and sFn,sTf, sTfR before and after chemotherapy.All the examinations were conducted by the clinical laboratory and bone-marrow laboratory in our hospital,sFn,sTf and sTfR were determined by chemiluminescence and nephelometry assay.And the normal level refers to reference range of our clinical and bone-marrow laboratory.Result:Before chemotherapy the level of sFn was increased significantly obviously in patients with hematological malignant disease compared with control (P＜0.05) and the level of sFn in newly diagnosed,relapse and non-remission patients was higher than that in remission group.The level of sTf in each group was lower than that of control significantly(P＜0.05).After chemotherapy,the level of sFn in remission group was decreased obviously,but which was still higher than control;sFn expression in non-remission group was not significant different from that before chemotherapy and control(P＞0.05).The level of sTf was still lower than control and there was no different between remission group and non-remission group after chemotherapy (P＞0.05).The level of sTfR in remission group before chemotherapy and non-remission group after chemotherapy were higher than that of control.Before chemotherapy the level ofβ₂-MG,LDH,especially in newly diagnosed,relapse and non-remission patients,were higher than those of control significantly(P＜0.05).After chemotherapy,the level of bothβ₂-MG and LDH decreased obviously(P＜0.05). Correlation analysis showed that there was positive correlation between the serum level of sFn and blast cells,β₂-MG,LDH(r =0.347,0.148,0.291 respectively)and there was negative correlation between sFn and hemoglobin(r=-0.207).There was no significant correlation between sFn and bone marrow iron.Conclusion:It is possible to predict that sFn is a useful index to evaluate chemotherapy effects and disease prognosis in patients with hematological malignant diseases after chemotherapy.Anemia in patients with tumor was not only referring to iron deficiency,so iron supplementation should be cautious.