title: Evaluation of serum soluble transferrin receptors and erythropoietin levels as indicators for erythropoietic activity among multi-transfused beta-thalassemic patients.
abstract: Eighty multi-transfused beta-thalassemics--40 of them on regular transfusion (RT) (every 3-4 weeks) and 40 irregularly transfused (IT)-and 20 age- and-sex-matched controls were evaluated for serum erythropoietin (sEpo) and soluble serum transferrin receptors (sTfr) as indicators of erythropoietic activity. All subjects were studied for pre-transfusion hemoglobin (Hb), reticulocytic index (RI), serum ferritin, sEpo and sTfr. Results showed that the mean RI, sEpo and sTfr values were significantly higher in the IT group (2.8; 80 mU/ml; and 19 microg/ml, respectively) compared to the RT group (1.2; 35.2 mU/ml; and 13.9 microg/ml, respectively) and controls (1.1; 22.6 mU/ml; and 7 microg/ml, respectively) (p < 0.05); while only the mean sTfr value was significantly higher in the RT group compared to controls. The mean pre-transfusion Hb was significantly lower in the IT group (8 g/dl) compared to both the RT group (9.3 g/dl) and controls (12.5 g/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. In summary, sEpo, sTfr and RI could be used as accurate and reliable indicators of successful erythroid marrow suppression and for the determination of optimal pre-transfusion Hb level in thalassemia on an individual basis, with sTfr being the most sensitive indicator.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Alexandria University, Egypt. dr_anawawy@yahoo.com
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Nawawy
authors.forename: Mohamed N
authors.initials: MN
authors.lastname: Massoud
authors.forename: Magdy
authors.initials: M
authors.lastname: El-Bordiny
authors.forename: Saeed
authors.initials: S
authors.lastname: Hegazya
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D011990:Receptors, Transferrin / Q000097:blood*; D012995:Solubility; D017086:beta-Thalassemia / Q000097:blood*
chemical_list: D006454:Hemoglobins; D011990:Receptors, Transferrin; D004921:Erythropoietin