输注不同治疗剂量血小板对急性淋巴细胞白血病患儿血清铁蛋白水平及短期预后的影响分析

Effect of Different Therapeutic Doses of Platelet Transfusion on Serum Ferritin Level and Short-Term Prognosis in Children with Acute Lymphoblastic Leukemia

目的:比较输注不同治疗剂量血小板对急性淋巴细胞白血病(Acute lymphocytic leukemia,ALL)患儿血清铁蛋白水平及短期预后的影响。方法:选取我院2019年3月至2021年3月收治的109例接受血小板输注治疗的ALL患儿,按照患儿单位体表面积实际输注血小板剂量,将输注剂量<2.2×10^(11)/m^(2)、2.2~4.4×10^(11)/m^(2)、>4.4×10^(11)/m^(2)者分别纳入低剂量组(n=37)、中剂量组(n=41)、高剂量组(n=31)。对比三组患儿血小板输注效果、24h血小板计数增加指数(CCI)、24h血小板回收率(PPR),以及血小板输注前后血清铁蛋白水平,并比较三组患儿1年存活情况。结果:低剂量组血小板/BSA、PPI低于中剂量组,中剂量组血小板/BSA、PPI低于高剂量组,差异有统计学意义(P<0.05);三组患儿CCI、输注有效率比较,未见统计学差异(P>0.05)。三组患儿血小板输注治疗期间均未见明显不良事件发生。两组患儿输注后24h血小板计数均较输注前升高,血清铁蛋白水平均较输注前下降,中剂量组输注前后血小板计数差值高于低剂量组,高剂量组输注前后血小板计数差值高于高剂量组,差异有统计学意义(P<0.05)。三组患儿治疗后1年存活率比较,未见统计学差异(P>0.05)。结论:输注不同治疗剂量血小板对ALL患儿血清铁蛋白水平及短期预后的影响差异不明显,中高剂量血小板输注并不会实现CCI提升,临床实践中可考虑低剂量血小板输注。

Objective:To compare the effects of different doses of platelet transfusion on serum ferritin level and short-term prognosis in children with acute lymphocytic leukemia(ALL).Methods:109 children with ALL who received platelet transfusion from March 2019 to March 2021 in our hospital were selected.According to the actual platelet transfusion dose per unit body surface area of the children,the transfusion doses of<2.2×10^(11)/m^(2),2.2~4.4×10^(11)/m^(2) and>4.4×10^(11)/m^(2) were respectively included in the low dose group(n=37).The effects of platelet transfusion,24-hour platelet count increase index(CCI),24-hour platelet recovery rate(PPR)and serum ferritin levels before and after platelet transfusion were compared among the three groups,and the 1 year survival of the three groups was compared.Results:The platelet/BSA and PPI of low dose group were lower than those of middle dose group,and the platelet/BSA and PPI of middle dose group were lower than those of high dose group(P<0.05).There was no significant difference in CCI and infusion efficiency among the three groups(P>0.05).There were no obvious adverse events in the three groups during platelet transfusion.24 hours after infusion,the platelet counts of both groups were higher than those before infusion,and the serum ferritin levels were lower than those before infusion.The difference of platelet counts before and after infusion in the middle dose group was higher than that in the low dose group,and the difference of platelet counts before and after infusion in the high dose group was higher than that in the high dose group,with statistical significance(P<0.05).There was no significant difference in the event-free survival rate among the three groups after treatment(P>0.05).Conclusion:Different therapeutic doses of platelet transfusion have no significant difference on serum ferritin level and short-term prognosis of children with ALL.Middle and high dose platelet transfusion can't improve CCI,so low dose platelet transfusion can be considered in clinical practice.