Anemia in Diffuse Large B cell Non-Hodgkin Lymphoma: The Role of IL-6, Hepcidin and Erythropoietin

Francesco D'Alo', Luigi Maria Larocca, Stefan Hohaus, Maria Chiara Tisi, Valentina Bozzoli, Manuela Giachelia, Giuseppina Massini, Bianca Maria Ricerca Storti, Elena Maiolo, Maria Teresa Voso, Giuseppe Leone, Alfonso Piciocchi, Harold Tjalsma, Dorine W. Swinkels

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34 Citations (Scopus)


Anemia is a frequent sign in patients with diffuse large B cell lymphoma (DLBCL) at diagnosis. We determined erythropoietin, hepcidin, and IL-6 in plasma samples of 53 patients with DLBCL. The majority of patients (40/53, 75%) showed defective endogenous erythropoietin production, in particular when anemia was present (p=0.01). Hepcidin plasma levels were significantly higher in patients compared to controls (p=0.006), particularly in those with characteristics associated with a more active disease, including elevated LDH (p=0.0004), B-symptoms (p=0.07) and an age-adjusted IPI score >1 (p=0.01). Hepcidin levels strongly correlated to ferritin (r=0.77, p<0.0001) and weakly to IL-6 concentrations (r=0.30, p=0.03), but not to haemoglobin values. IL-6 inversely correlated to haemoglobin values both in univariate and multivariate analysis (p=0.04), including hepcidin and erythropoietin as variables. Our findings suggest that elevated hepcidin levels and inadequate erythropoietin response are frequent in DLBCL, but elevated IL-6 plays the major role for the development of anemia.
Original languageEnglish
Pages (from-to)N/A-N/A
Publication statusPublished - 2013


  • Anemia
  • NHL


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