Serum Hepcidin Level in Patients with Acute Lymphoblastic Leukemia (ALL) during The Treatment Phase: Their Effects on Erythropoisis Activity and Iron Reserves

Hepcidin levels increased significantly with increased of iron stores in early phase of acute leukemia patients when erithropoisis pressed by blast cells in bone marrow, then decreased significantly with acute leukemia remission. The study aimed to determine role of hepcidin in activity of erythropoisis and serum iron reserves in acute lymphoblastic leukemia (ALL) patients during phase of therapy. This study used an observational analytic design. Serum hepcidin examination used ELISA methods. Erythropoisis activity was determined by complete blood and reticulocyte percentage. Iron reserves was determined by serum iron and ferritin levels by ECLIA. Result shows a total of 48 patient subjects were divided into groups of induction, consolidation and maintenance phase with an average age of 6.81 years (induction), 9.7 years (consolidation) and 7.8 years (maintenance). In the normality test with Shapiro-Wilk data showed abnormal distribution (p <0.05). Analysis by the Kruskal-Wallis test showed there were differences between the three treatment phases in the examination of hemoglobin, reticulocytes, serum iron, ferritin and hepcidin (p <0.05). In statistical analysis with Spearman's rank correlation shows there is a significant correlation between hemoglobin with ferritin (r = -0.416, p = 0.003), hemoglobin with hepcidin (r = -0.305, p = 0.035), reticulocytes with hepcidin (r = -0.496), p = 0.000) and serum iron with hepcidin (r = -0.302, p = 0.037). We concluded that the higher levels of hepcidin indicate lower levels of hemoglobin, reticulocytes and serum iron in patients with acute lymphoblastic leukemia during treatment phase.