Erythropoiesis and iron metabolism after hematopoietic stem cell transplantation

After hematopoietic stem cell transplantation (HCT), many patients present anemia, which can persist for months due to an inadequate Epo production for the degree of the anemia. In this thesis, we performed two randomized studies with erythropoiesis-stimulating agents (ESA) therapy after allogeneic (including myeloablative and non-myeloablative conditioning) and autologous transplantation. We showed a great efficacy of this growth factor to ensure full erythroid reconstitution when initiated soon after engraftment, and not immediately after the transplant. Furthermore, as iron parameters are quite disturbed following HCT, we sought to study iron metabolism after HCT (which has not been much investigated), integrating the role of hepcidin, the key regulator in iron metabolism. Hence, we demonstrated that hepcidin levels prior to and following autologous HCT were influenced by iron stores and changes in erythropoietic activity