Pathogenetic Characteristics of Anemia in Patients with Solid Tumors

Abstract

Aim. To study the impact iron metabolism disturbances and cytokine levels on the development of anemia in patients with solid tumors. Materials & Methods. The research included 42 patients with malignant neoplasms, including 24 patients with anemia (19 men and 5 women, median age 67.7 ± 10 years) and 18 patients without anemia (15 men, 3 women, median age 65.7 ± 14 years). Anemia was diagnosed according to the WHO criteria (in men: erythrocytes < 4.0 <sup>x</sup> 10<sup>12</sup>/L, hemoglobin < 130 g/L, hematocrit < 39 %; in women: erythrocytes < 3.8 <sup>x</sup> 10<sup>12</sup>/L, hemoglobin < 120 g/L, hematocrit < 36 %). Results. A comparative analysis of iron metabolism in patients with and without anemia was performed. The lower values of serum iron and transferrin saturation in patients with anemia were shown (p < 0.05). The total iron-binding capacity, the levels of ferritin, transferrin, C-reactive protein, indirect bilirubin were similar between groups (p > 0,05). Higher levels of interleukins 6 and 10 (IL-6 and IL-10) were observed in patients with anemia (p < 0.05). For IL-6, correlations were observed with levels of erythrocytes (r = -0,58), hemoglobin (r = -0,57), hematocrit (r = -0,52), and leukocytes (r = 0,42). The levels of IL-10 slightly correlated with the levels of erythrocytes, leukocytes, platelets, MCV, and MCH (r < 0.3). For IL-10, correlations were established with levels of MCHC (r = -0,71), hemoglobin (r = -0,64) and hematocrit (r = -0,32). Correlations between the levels IL-6, IL-6 and hemoglobin, erythrocytes and several color indices may indicate their influence on the development of anemia in patients with malignant neoplasms. Conclusion. A functional iron deficiency in patients with anemia was found. Several causes of anemia development and significant role of interleukins in anemia pathogenesis were also discovered.