The Study On Hepcidin、Il-6and STfR In Children With Lymphoma

Background and ObjectiveLymphoma is one of malignant neoplasms derived from a monoclonalproliferation of B or T-lymphocytes and less commonly natural killer (NK) cells,which is common in blood system in children. The incidence of lymphoma is inferiorto leukemia and brain tumors for children, and in recent years, has a obvious risingtrend. Anemia, used to be called anemia of chronic disease(ACD), is a presentingsymptom of patients with lymphoma, and usually seen in chronic infection,inflammation, autoimmune diseases, cancer, etc. The mechanism of ACD is related toinflammatory cytokines of body. Anemia not only affects the patient’s quality of life,also has a negative impact on survival. The abnormality of iron metabolism caused byinflammatory cytokines play a crucial role abnormality in anemia of inflammation.Hepcidin plays a role of negative regulation of iron metabolism, and is crucialfactor for the mechanism of ACD, by inhibiting the absorption of iron from theintestine, and blocking the release of iron from the reticuloendothelial system. IL-6isthe most important cytokine of stimulating expression of hepcidin, which regulatesiron mechanism by increased hepcidin, resulting in anemia. IL-6and hepcidin couldassociate inflammation with iron metabolism at the molecular level, which play a keyrole in ACD. Serum soluble transferrin receptor (sTfR) due to the influence of iron in the body, can be used as the important indicator of evaluating iron stores and bonemarrow hemocytogenesis.Now the mechanism of lymphoma associated anemia is still not clear, and thereis no research data on serum hepcidin and inflammatory cytokines in patients withlymphoma at home. In this study, We preliminary analyze the relationship betweenthem and lymphoma associated anemia, through determining the expression level ofserum hepcidin, IL-6and the sTfR, and analyzing the relevance between them, so asto further disclose the pathogenesis of lymphoma associated anemia, and providerational basis for clinical therapy.MethodsCollect the peripheral blood of69patients with lymphoma in children fromPediatric Hematology and Oncology and Pediatric surgery of the First AffiliatedHospital of Zhengzhou University, Children’s hospital of Zhengzhou city andMaternity and Child Health Care of He-Nan province between2011to2013. The69patients were diagnosed definitely lymphoma by histopathology, and ruled out ofbone marrow infiltration. Patients were divied into2groups,15cases with anemia,and54cases without anemia. A group of15healthy children was used as a control.The hepcidin, IL-6and sTfR in serum were measured by ELISA.Observe theexpression difference and correlation of hepcicin, IL-6and sTfR. In addition, recordclinical characteristics and the hepcidin, IL-6and sTfR level status.Results1. The difference about hepcidin, IL-6and sTfR was statistically significant inthe three groups (P<0.001). The expression of hepcidin, IL-6and sTfR in lymphomawith anemia group were higher compared with lymphoma without anemia group andhealthy control(P<0.01).2. In lymphoma with anemia group, hepcidin levels inversely correlated withhemoglobin levels (r=-0.762,P=0.003), positively correlated with IL-6(r=0.657,P=0.014), and also positively correlated with sTfR (r=0.758，P=0.001). 3. Serum hepcidin, IL-6and sTfR were higher in high risk group and Bsymptom group than low risk group and non-B symptom group. Hepcidin levels ingroups with high LDH were obviously higher than groups with low LDH，and thedifference was statistically significant (P＜0.05).Conclusions1. The expression of hepcidin、 IL-6and sTfR increased significantly inlymphoma with anemia in children.2. In lymphoma children with anemia, the expression of hepcidin and IL-6increased，sTfR significantly increased. These changes may be related to lymphomaassociated anemia.3. The expression of hepcidin, IL-6and sTfR was related to the clinical features.