急性白血病患者红细胞输注效果的影响因素探讨

The impacting factors of RBC transfusion efficacy in acute leukemia patients undergoing induction and consolidation treatment

目的了解急性白血病患者的红细胞输注情况,探讨影响急性白血病患者红细胞输注效果的因素。方法回顾性收集2017年12月—2018年12月在本院血液科治疗的87例急性白血病患者的资料,详细记录其初诊至1年内每次住院的红细胞输注情况,探讨年龄、性别、既往输血量等临床因素与红细胞输注有效率的关系。结果87例急性白血病患者1年内共计输注红细胞554次,输血有效次数为396次,输血有效率71.5%。单因素分析显示:男性患者的输血有效率明显低于女性(67.8%vs 75.9%,P<0.05);年龄不同输血有效率不同(≤15岁、16—40岁、41—60岁、>60岁的输血有效率分别为:80.5%、60.5%、72.8%、77.9%,P<0.05);既往输血量不同输血有效率亦不同(≤10 U vs 10—20 U vs>20 U:69.9%vs 67.4%vs 83.7%,P<0.05);输血间隔时间(≤10 d vs 10—30 d vs>30 d:66.8%vs 70.1%vs 83.2%,P<0.05)、骨髓抑制程度不同(77.5%vs 68.8%,P<0.05)输血有效率亦有明显差别。多因素Logistic回归分析显示:年龄、输血间隔时间和骨髓抑制程度是红细胞无效输注的独立影响因素。结论影响急性白血病患者红细胞输注效果的可能因素有:年龄、输血间隔时间、骨髓抑制程度、既往输血量及疾病的治疗控制情况。

Objective To study the efficacy of red cell transfusion in acute leukemia patients undergoing induction and consolidation treatment,so as gain insight and knowledge on the best transfusion practices in this high risk population.Methods The data of 87 patients with acute leukemia(AL)treated in hematology department of our hospital from December 2017 to December 2018 were collected retrospectively.The medical record data within one year following the initial diagnosis were recorded in detail.The association between the efficacy of RBC transfusions and patients'gender,age and previous transfusion volume were analyzed.Results The numbers of RBC transfusion administered in 87 AL patients within one year after initial diagnosis were 554,among which 396 were effective,with an effective rate of 71.5%.Single factor analysis showed that the effective rate of RBC transfusion in male patients(67.8%)was significantly lower than that in female(75.9%)(P<0.05).The same differences also existed among age groups(P<0.05);the effective rate of RBC transfusion in≤15 years old,16—40 years old,41—60 years old,and>60 years old was 80.5%,60.5%,72.8%and 77.9%,respectively(P<0.05).The efficacy of RBC transfusion also differed among patients with different volumes of previous transfusion(≤10 U vs.10—20 U vs.>20 U:69.9%vs.67.4%vs.83.7%,P<0.05)different interval time of transfusion((≤10 d vs.10—30 d vs.>30 d:66.8%vs.70.1%vs.83.2%,P<0.05)and degree of bone marrow suppression(77.5%vs.68.8%,P<0.05).Multivariate logistic regression analysis revealed that age,interval time of transfusion and degree of bone marrow suppression were independent factors for ineffective RBC transfusions.Conclusion The possible risk factors affecting the efficacy of RBC transfusion in AL patients were age,blood transfusion interval time,degree of bone marrow suppression,previous transfusion volume and treatment and control of diseases.