ANEMIA OF CHRONIC DISEASES - THE KEY MECHANISMS OF PATHOGENESIS AND THE ATTEMPT OF THE CLASSIFICATION

Abstract

Objective: The study objective is to determine the role of cytokines, hepcidin and soluble transferrin receptor (sTfR) in anemia pathogenesis in patients with malignant neoplasms and to suggest a working version of the pathogenetic classification of anemia of chronic diseases. Methods: 63 patients with stage II-IV of a malignant neoplasm were examined. Anemia (1^st group) was diagnosed in 41 people, in 22 cases no signs of anemia were found (2^nd group). A comparative analysis of the metabolism of iron, C-reactive protein (CRP), hepcidin, sTfR, as well as interleukins (IL) 6 and 10 and tumor necrosis factor a (TNFa) was performed. Results: Patients with anemia compared with group 2 in the serum of peripheral blood showed lower levels of iron, total iron binding capacity, transferrin saturation coefficient with iron, and higher concentrations of CRP, hepcidin, sTfR, IL6, IL10 and TNFa. Conclusions: Based on the correlation analysis, a multicomponent genesis of anemia in malignant tumors was demonstrated. A working version of the classification of anemia of chronic diseases based on the leading pathogenetic factor is proposed: 1) primary iron deficiency, 2) disruption of the regulatory mechanisms of erythropoiesis, 3) insufficient erythropoietin production.