移植后铁蛋白升高预测异基因造血干细胞移植血小板植入延迟

Elevated ferritin after transplantation predicts delayed platelet implantation in allogeneic hematopoietic stem cell transplantation

目的探究异基因造血干细胞移植后血清铁蛋白水平升高和血小板植入延迟的关系。方法回顾性分析2018年1月至2021年8月的170例接受异基因造血干细胞移植患者的临床资料,分析移植后铁蛋白水平升高和血小板植入延迟的关系。根据移植后血清铁蛋白水平的中位值,将其分为高铁蛋白组(≥2641 ng/mL)和低铁蛋白组(<2641 ng/mL),通过χ^(2)检验分析移植后铁蛋白升高对血小板植入的影响。纳入年龄、性别、移植前血红蛋白水平、血小板水平、CD34^(+)细胞输注数量、巨细胞病毒(CMV)感染等可能会影响血小板植入的因素,进行单因素分析,P<0.1的因素再进行多因素分析。结果单因素分析显示移植后铁蛋白升高与血小板植入延迟相关(P=0.003)。通过logistic多因素回归分析得出CD34^(+)细胞输注量<5×10^(6)/kg、CMV再激活、移植后铁蛋白水平升高是移植后血小板植入延迟的独立危险因素(P<0.05)。结论移植后的血清铁蛋白水平升高与移植后血小板植入延迟相关,是移植后血小板植入延迟的独立危险因素,检测移植后血清铁蛋白水平或可以为移植后血小板延迟植入的防治提供指导。

Objective To investigate the correlation between elevated ferritin level and delayed platelet implantation after allogeneic hematopoietic stem cell transplantation.Methods The clinical data of 170 patients who underwent allogeneic hematopoietic stem cell transplantation from January 2018 to August 2021 were retrospectively analyzed,and the correlation between elevated ferritin level and delayed platelet implantation after transplantation was analyzed.According to the median ferritin level after transplantation,they were divided into high ferritin group(≥2641 ng/mL)and low ferritin group(<2641 ng/mL),and the effect of elevated ferritin on platelet implantation after transplantation was analyzed by chi-square test.Factors that may affect platelet implantation,such as age,gender,hemoglobin level and platelet level before transplantation,CD34^(+)dosage,and cytomegalovirus(CMV)infection,were included.Results Univariate analysis showed that elevated ferritin was significantly associated with delayed platelet implantation after transplantation(P=0.003).According to logistic multivariate regression analysis,CD34^(+)cell dosage<5×10^(6)/kg,CMV reactivation,and elevated ferritin levels after transplantation were independent risk factors for platelet implantation delay after transplantation(P<0.05).Conclusion The elevated ferritin level after transplantation is correlated to the delay in post-transplant platelet implantation,which is an independent risk factor for the delay of platelet implantation after transplantation.The detection of ferritin level after transplantation may provide guidance for the prevention and treatment of delayed platelet implantation after transplantation.