Soluble Transferrin Receptor Discriminates Iron Deficiency Anemia from Anemia of Chronic Disease in Leukemic and Breast Cancer Patients

¹Hematology Division, Department of Biomedical Sciences, Ladoke Akintola University of Technology, Osogbo. Nigeria.

² Department of Hematology & Blood Transfusion, Ladoke Akintola University of Technology, Osogbo. Nigeria.

³Department of Surgery, Ladoke Akintola University of Technology, Ogbomoso. Nigeria.

⁴Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso. Nigeria.

⁵Department of Chemical Pathology, Ladoke Akintola University of Technology, Ogbomoso. Nigeria.

*Corresponding Author

Dr. V.O. Mabayoje

Department of Hematology & Blood Transfusion

Ladoke Akintola University of Technology

P.M.B. 4400

Osogbo. Nigeria

Tel: +234-803-3294874

E-mail: tunjimabs@yahoo.com

Abstract

Anemia is a global public health problem, affecting about 30% of the world's population. Association of iron deficiency with some chronic diseases is inevitable, hence the necessity to differentiate between anemia of chronic disease and iron deficiency anaemia (IDA). The present study was conducted to discriminate iron deficiency anemia from that due to leukemia and breast cancer as this would help to avoid unnecessary and invasive investigative procedures and also treatment outcomes. Sixty patients drawn from each condition of chronic leukaemia, female breast cancer, other anemic conditions as well as apparently healthy subjects who served as controls were included in the study totalling two hundred and twenty four participants from various clinics of Ladoke Akintola University Teaching Hospital, Osogbo and Abake medical centre Osogbo. Soluble serum transferrin receptor (sTfR) level was determined using Enzyme Linked Immunosorbent Assay (ELISA) with kit from R&D, Biosystems, UK with the hematocrit determined using the automated method by Sysmex 2006 facility. Serum transferrin receptor level in anemic patients is significantly higher than in control subjects (p<0.05) indicating anemia due to iron deficiency while no significant difference (p>0.05) in sTfR was obtained between breast cancer and control subjects. Leukemia subjects however had a significantly lower sTfR level compared to the control subjects. All the test groups had hematocrit level significantly lower (p<0.05) than the control group. This study indicates that the anemias observed in breast cancer and leukemia patients are due to anemia of chronic disease (ACD), while anemia in the other anemic patients group is more consistent with iron deficiency anemia. Serum transferrin receptor assay could therefore be a useful non-invasive diagnostic blood test and monitoring and differentiating tool for clinical IDA, and ACD.

Keywords: Soluble serum transferrin receptor, Breast cancer, Leukemia, Anemia, Iron, deficiency, ELISA.

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