Serum Transferrin Receptor in Relation to Iron Status in Different Disease Stages of Adult Malignant Lymphoma

Background: Soluble transferrin receptor is a new diagnostic tool for determining iron status and erythropoietic activity. The objective of this study was to evaluate the diagnostic efficiency of serum soluble transferrin receptor (sTfR) measurements together with the estimation of bone marrow iron stores in different phases of non-Hodgkin’s lymphoma (NHL), in an attempt to assess the iron status of NHL patients. Patients & Methods: The study was carried on 75 adult patients diagnosed as NHL at the National Cancer Institute, Cairo University. Hematological studies and bone marrow (BM) aspirate examination for cellularity, sideroblasts and marrow iron stores were done. Iron metabolism investigations including serum iron, iron -binding capacity, % saturation, ferritin and transferrin receptors (sTfR) were carried out. All the parameters were evaluated at different NHL phases of disease and compared in anemic and non-anemic patients. Results: A significant increase in sTfR and BM iron stores was found in new and relapsing cases and in advanced stages of the disease, with normal levels in patients in remission. The difference between anemic and nonanemic NHL patients was mainly in levels of serum ferritin and TfRs and in BM iron stores. Conclusions: This study showed elevated sTfR levels in adult NHL patients inspite of having abundant iron stores, and that its level reflected the activity and stage of the disease rather than iron status in this type of hematological malignancy.