Date Published: 
Monday, 10 November, 2014

Hepcidin may be used to differentiate between iron deficiency anaemia and anaemia of chronic disease in cancer patients, new study shows

Hepcidin may differentiate between types of anaemia, which may lead to varied therapeutic strategies, according to new research. Authors suggest that hepcidin may be more effective as a diagnostic marker of anaemia in cancer patients than serum iron, total iron-binding capacity (TIBC), or transferrin saturation (TSAT). They state that hepcidin could be used as a serological marker in the differential diagnosis of tumour-related anaemia of chronic disease (ACD) and iron deficiency anaemia.

Iron deficiency anaemia and ACD are both prevalent in patients with cancer. Differential diagnosis of the two conditions can be difficult in clinical practice, which hampers targeted treatment. This study evaluated the use of hepcidin to differentiate between tumour-related iron deficiency anaemia (which is associated with absolute iron deficiency) and ACD (which may be accompanied by normal iron status or functional iron deficiency).

Serum hepcidin levels of cancer patients with iron deficiency anaemia, ACD, or neither condition were measured. Prussian blue staining of bone marrow smears, which is considered the gold standard test for discriminating between iron deficiency anaemia and ACD, were measured in these patients. Serum iron, TIBC, TSAT, interleukin-6 (IL-6), and tumour necrosis factor a (TNF-a) were also measured, as comparable serological biomarkers. The study did not measure serum ferritin.

Consistent with previous reports, hepcidin levels showed a decreasing trend from the tumour-related ACD group (138.52 ± 49.66 ng/mL) to the control group (78.54 ± 14.21 ng/mL) to the tumour-related iron deficiency anaemia group (64.14 ± 15.88 ng/mL). Further statistical analysis showed that hepcidin had a higher diagnostic predictive value, specificity and sensitivity than either serum iron, TIBC or TSAT, in patients with ACD and iron deficiency anaemia.

The authors suggest that future use of hepcidin as a diagnostic tool could ensure patients with tumour-related anaemia receive the appropriate corrective treatment. The full article is available in the European Journal of Haematology. For further information on diagnosing iron deficiency in cancer, please click here.