EVALUATION OF SERUM
SOLUBLE TRANSFERRIN RECEPTORS AND ERYTHROPOIETIN LEVELS AS INDICATORS FOR
ERYTHROPOIETIC ACTIVITY AMONG MULTI-TRANSFUSED b-THALASSEMI PATIENTS
El-Nawawy A, Massoud MN, El-Bordiny M,
Hegazy S
El-Shatby Children¡¯s Hospital, Faculty of
Medicine, Alexandria, Egypt
Objective: Evaluation
of serum erythropoietin (sEpo) and soluble serum transferrin receptors
(sTfr) as indicators for erythropoietic activity among multi-transfused b-Thalassemics.
Methods: Eighty
multi-transfused b- thalassemics: 40 of them on
regular transfusion (RT) (every 3-4 weeks), 40 irregularly transfused (IT),
and 20 age and sex matched controls were the subjects of the study. All
subjects were studied for pretransfusion hemoglobin (Hb), reticulocytic
index (RI), serum ferritin, sEpo and sTfr.
Results: Results showed that
the mean RI, sEpo and sTfr values were significantly higher in the IT group
(2.8, 80mu/ml, 19 ug/ml respectively) compared to the RT group (1.2, 35.2
mU/ml and 13.9 ug/ml respectively) and controls (1.1, 22.6 mU/ml and 7
ug/ml respectively) (P<0.05), while only the mean sTfr value was
significantly higher in the RT group compared to controls. The mean
pretransfusion Hb was significantly lower in the IT group (8g/dl) compared
to both the RT group (9.3g/dl) and controls (12.5g/dl) (P<0.05); while
the RT group level was significantly lower than controls. There was an
inverse correlation between Hb level on one hand and sEpo (r= - 0.324,
P<0.05), sTfr (r=-0.651, P<0.05) and RI (r= - 0.451, P< 0.05) on the
other.
Conclusion: In summary, sEpo,
sTfr and RI could be used as accurate and reliable indicators of optimal
pretransfusion Hb level, in thalassemics, on individual basis, with sTfr
being the most sensitive indicator.