Prognostic Value of the Serum Hepcidin and Ferritin in Pretransplant Multiple Myeloma Patients

Document Type : Original Article

Authors

1 Department of Clinical pathology , faculty of medicine, Aswan University

2 Department of internal medicine and clinical hematology, Ain shams University, Egypt

Abstract

Despite advances in hematopoietic stem cell transplantation (HSCT) and novel therapies, MM remains incurable. Hepcidin and ferritin, regulators of iron metabolism, have been studied as potential prognostic markers, but their role in transplant outcomes remains unclear. This study aimed to assess pre-transplant serum levels of ferritin, hepcidin, iron, and C-reactive protein (CRP) in MM patients and correlate these markers with post-transplant outcomes.
Methods: A total of 31 MM patients eligible for autologous HSCT were compared with 20 healthy controls. Serum levels of ferritin, hepcidin, iron, and CRP were measured before transplantation. Post-transplant outcomes, including engraftment time, complications, and overall survival (OS), were assessed.
Results: Elevated pre-transplant ferritin levels (≥160 ng/mL) were associated with delayed engraftment (p=0.036) and increased bacterial infections (p=0.048). CRP levels ≥0.671 mg/mL correlated with delayed engraftment (p=0.044). Low pre-transplant albumin (<3.5 g/dL) and platelet counts (<150x103/mm3) were linked to poorer OS (p=0.050 and p=0.013, respectively). However, hepcidin, iron, and CRP levels were not significantly associated with OS.
Conclusions: Pre-transplant ferritin levels are predictive of longer engraftment and higher infection risk in MM patients undergoing HSCT. Frritin serves as a key predictor of post-transplant complications.

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