目的:铁过载(IO)是AL和HCT患者治疗中常见的危及生命的并发症。这项研究旨在评估12种血清铁代谢生物标志物在接受AL治疗或接受HCT的儿科患者中的预后价值。
方法:总的来说,前瞻性纳入了50例强化治疗后的AL患者和32例HCT后的AL患者。诊断时的AL患者和健康对照者作为参照组。
方法:分析了以下12项血清铁代谢参数对AL/HCT患者预后的影响:铁,转铁蛋白(Tf),总铁结合能力(TIBC),铁蛋白,铁蛋白重链(FTH1),铁蛋白轻链(FTL),铁调素,可溶性血瘀素(sHJV),可溶性亚铁转运蛋白-1(sFPN1),红细胞铁蛋白(ERFE),促红细胞生成素(EPO),和可溶性转铁蛋白受体(sTfR)。
结果:中位随访时间为2.2年,高水平的铁蛋白和低水平的sHJV对HCT术后儿童的OS和EFS有不良预后影响.如果这些患者与强化化疗后患有AL的患者合并,铁蛋白和sHJV的OS和EFS结果均得到证实。
结论:在12个分析的铁代谢血清参数中,铁蛋白水平升高和sHJV水平降低对HCT术后儿童的预后有不利影响.需要更多的数据来澄清铁蛋白之间的关系,sHJV,强化化疗后AL儿童的死亡率,需要更广泛的前瞻性研究来证明sHJV的预测性。
OBJECTIVE: Iron overload (IO) is a common and life-threatening complication resulting from the therapy of AL and HCT patients. This study aimed to evaluate the prognostic value of 12 serum biomarkers of iron metabolism in pediatric patients treated for AL or undergoing HCT.
METHODS: Overall, 50 patients with AL after intensive treatment and 32 patients after HCT were prospectively included in the study. AL patients at diagnosis and healthy controls served as reference groups.
METHODS: The impact of the following 12 serum iron metabolism parameters on the outcome of AL/HCT patients was analyzed: iron, transferrin (Tf), total iron-binding capacity (TIBC), ferritin, ferritin heavy chains (FTH1), ferritin light chains (FTL), hepcidin, soluble
hemojuvelin (sHJV), soluble ferroportin-1 (sFPN1), erythroferrone (ERFE), erythropoietin (EPO), and soluble transferrin receptor (sTfR).
RESULTS: With a median follow-up of 2.2 years, high levels of ferritin and low levels of sHJV had an adverse prognostic impact on OS and EFS in children after HCT. If these patients were combined with those with AL after intensive chemotherapy, the results were confirmed for OS and EFS both for ferritin and sHJV.
CONCLUSIONS: Among the 12 analyzed serum parameters of iron metabolism, increased levels of ferritin and decreased levels of sHJV had an adverse prognostic impact on survival in children after HCT. More data are needed to clarify the relationship between ferritin, sHJV, and mortality of AL children after intensive chemotherapy, and more extensive prospective studies are required to prove sHJV predictivity.