Patients undergoing Hematopoietic stem cell transplantation are at risk of infection at different phases of the transplantation. Ferritin and hepcidin are postulated to be major players that linking inflammation or infection with iron homeostasis.In this study, pre-transplant serum ferritin and hepcidin were assessed in 50 patients who underwent HSCT and 50 healthy persons as controls. Median level of serum hepcidin was higher in the patients' group than the control group. Forty patients (80%) had episodes of infections in first 100 days post-transplant. Patients with post[1]transplant infections had significantly higher mean level of serum hepcidin (p value=0.001) and a significant positive correlation between serum hepcidin and serum ferritin.However the hepcidin specificity (80% at cutoff value of 222ng/ml) was better than ferritin specificity (60% at cutoff value of 205 ng/ml) in predicting early post HSCT infection. Meanwhile, Ferritin specificity (65% at cutoff value of 250ng/ml) was better than hepcidin specificity (52% at cutoff value of 217ng/ml) in predicting survival in first 100 days after transplant. Conclusion: serum hepcidin was more specific than serum ferritin as a predictor for early post HSCT infection while serum ferritin has higher specificity for overall survival in first 100 days post-transplant. The results encourage pre-transplant assessment of serum hepcidin level as a part of the routine work up and administration of iron chelators to decrease incidence of infections and improve outcome.
