地中海贫血高血清铁蛋白与造血干细胞移植后血细胞恢复的关系

摘要

Objective Purpose To find out the causes of Cytopenia post engraftment (CPE) in hematopoietic stem cell transplantation (HSCT) for patients with β-thalassemia major (β-TM ). Methods We retrospectively analyzed 61 consecutive β-TM patients who underwent 7/8 HLA matched HSCT from January 1, 2009 to June 30, 2015. Thirty-eight patients suffered from CPE and the remainder (n = 23) without CPE. The effect of pre-transplant ferritin (PTSF) and recipient and donor age on CPE were analyzed in the two groups. The CPE was defined as white blood cell counts less than 3.0 x 109/L for four weeks or longer without infection of cytomegalovirus, human parvovirus B19 virus and Epstein-Barr virus. Results In univariate analysis, the PTSF level was the risk factor for CPE and significantly higher in CPE group than no-CPE group (3927.9 ± 1314.9 ng/mL vs 2291.0 ± 994.4 ng/mL, P = 0.000). The result was also proved by multi-factor binary regression analysis (P =0.001). The optimal value of PTSF level by R language(R 2.15.2) is 2500ng/mL, which is cut off value in the two groups. Conclusions The current study indicated that high PTSF level is a high-risk factor of CPE for β-TM patients who underwent 7/8 HLA-matched HSCT, and PTSF should be reduced below 2500 ng/L if the 7/8 matched HSCT must be done.%目的研究重型β地中海贫血(地贫)造血干细胞移植(HSCT)植入后血细胞减少 (CPE)的影响因素.方法对2009年1月1日-2015年6月30日在本中心行7/8 HLA相合 HSCT治疗的61例地贫患者进行了回顾性分析.61例患者分为CPE组(n = 38)和无CPE组 (n =23),运用单因素和多因素回归分析对两组中移植前铁蛋白(PTSF)、供者年龄、受者年龄与 CPE的相关性.结果在单因素分析中证明PTSF为CPE的危险因素.CPE组PTSF水平明显高于无 CPE组(3927.9 ± 1314.9 ng/mLus2291.0 ±994.4 ng/mL, P =0.000).同样的结果在多因素回归分析中也被证实(P =0.001).运用R语言(R 2.15.2)校正两组中PTSF界限值为 2500 ng/mL.结论高PTSF是7/8 HLA相合地贫HSCT发生CPE的高危因素,在地贫患者接受 7/8 HLA相合 HSCT时,PTSF应降至2500 ng/mL以下.