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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

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Volume 51, Issue 9


Anemia and iron biomarkers in patients with early breast cancer. Diagnostic value of hepcidin and soluble transferrin receptor quantification1)

Anna Durigova
  • Department of Medical Oncology, CRLC Val d’Aurelle, Montpellier, France
  • Anna Durigova and Pierre-Jean Lamy contributed equally to this work.
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Pierre-Jean Lamy
  • Corresponding author
  • Biothèque-Biological Resource Center, CRLC Val d’Aurelle, Montpellier, France
  • Anna Durigova and Pierre-Jean Lamy contributed equally to this work.
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Simon Thezenas / Stephane Pouderoux / Frédéric Montels / Gilles Romieu / Marian Gutowski / William Jacot
Published Online: 2013-06-20 | DOI: https://doi.org/10.1515/cclm-2013-0031


Background: Anemia, a frequent and deleterious condition in patients with cancer, is mainly caused by chemotherapy toxicity, iron deficiency, or inflammation. We evaluated the baseline iron metabolism biomarkers and their association with anemia occurrence during chemotherapy in patients with early breast cancer (EBC).

Methods: In this monocentric retrospective study, classical iron metabolism markers and new biomarkers as well as sTfR and hepcidin were assessed at baseline in 347 patients with EBC who received a sequential taxane and anthracycline-based regimen between April 2007 and October 2009. Hemoglobin level was measured every 21 days.

Results: Thirty-five patients had baseline iron deficiency and 13 inflammatory iron sequestration. In multivariate analysis, only high sTfR (OR=27.6, p<0.001, 95% CI 8.74–87) and pre-menopausal status (OR=7.3, 95% CI 0.04–0.43, p=0.001) remained statistically associated with iron deficiency. High hepcidin values and inflammatory iron sequestration were significantly associated (p=0.032). In total 6.1% patients had baseline anemia and 86.2% patients developed anemia during chemotherapy (41 had grade ≥2 anemia). Baseline hemoglobin below 13 g/dL and low hepcidin levels were the two independent predictive factors of severe anemia.

Conclusions: In early breast cancer treated by chemotherapy, only baseline hemoglobin and hepcidin levels are independent predictive factors of anemic syndrome occurrence.

This article offers supplementary material which is provided at the end of the article.

Keywords: anemia; breast cancer; hemoglobin; hepcidin; iron metabolism; soluble transferrin receptor


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About the article

Corresponding author: Dr. Pierre-Jean Lamy, Department of Biology and Oncogenetic, CRLC Val d’Aurelle, 208 rue des Apothicaires, 34298 Montpellier Cedex 5, France, Phone: +33 467613139, Fax: +33 467632873

Received: 2013-01-10

Accepted: 2013-05-30

Published Online: 2013-06-20

Published in Print: 2013-09-01

This article was presented in part at the 17th International Meeting of the European Society of Gynaecological Oncology, Milan, Italy, September 11–14, 2011.

Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 51, Issue 9, Pages 1833–1841, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2013-0031.

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