Serum Soluble Transferrin Receptor Concentration as a Biomarker of Erythropoietic Activity: Surrogate Marker of Adequate Transfusion in Adult Beta-Thalassaemia Intermedia Patients
- Author:
S Thambiah, E George
;
U Nor Aini
;
J Sathar
;
H Zarida
;
Mokhtar AB
- Publication Type:Journal Article
- Keywords:
Serum soluble transferrin receptor;
serum ferritin;
β-thalassaemia intermedia/HbE-β-thalassaemia;
ineffective erythropoiesis
- From:Malaysian Journal of Medicine and Health Sciences
2013;9(2):3-12
- CountryMalaysia
- Language:English
-
Abstract:
Management of Beta (β)-thalassaemia intermedia in contrast to β-thalassaemia major patients has no
clear guidelines as to indicators of adequate transfusion. Regular blood transfusion suppresses bone
marrow erythropoietic activity. Serum soluble transferrin receptor (sTfR) concentration is a marker
for erythropoietic activity, with increased sTfR being associated with functional iron defi ciency and
increased erythropoietic activity. This study aimed to determine the use of sTfR as an indicator of
adequate transfusion in adult β-thalassaemia intermedia patients. A cross-sectional study was conducted
at Hospital Ampang, Malaysia, for six months. Patient group included six β-thalassaemia intermedia
and 34 HbE-β-thalassaemia transfused patients. None of the patients were on regular monthly blood
transfusions as in β-thalassaemia major. The control group comprised of 16 healthy subjects with normal
haematological parameters. Haemoglobin (Hb) analysis, sTfR and ferritin assays were performed. Hb
and HbA percentages (%) were found to be signifi cantly lower in patients compared to the controls,
while HbE%, HbF%, sTfR and ferritin were signifi cantly higher in patients. An inverse relationship was
found in the controls between HbF% with Hb (r = -0.515, p < 0.05) and HbA% (r = -0.534, p < 0.05).
In patients, sTfR showed an inverse relationship with HbA% (r = -0.618, p = 0.000) and a positive
correlation with HbE% (r = 0.418, p = 0.007) and HbF% (r = 0.469, p = 0.002). Multivariate analysis
showed that HbA% (r = 2.875, p = 0.048), HbE% (r = 2.872, p = 0.020) and HbF% (r = 2.436, p = 0.013)
best predicted sTfR independently in patients. Thus, sTfR is a useful marker for erythropoiesis. The elevated
sTfR in these patients indicate that the transfusion regimen used was inadequate to suppress ineffective
erythropoiesis. Hb levels may not be the best target for monitoring transfusion treatment in β-thalassaemia
intermedia patients, but the use of sTfR is helpful in individualising transfusion regimens.
- Full text:P020150604582835133444.pdf
