Laboratory characteristics comparison between patients with refractory anemia and megaloblastic anemia: a Meta-analysis
10.3760/cma.j.cn115356-20191201-00227
- VernacularTitle:难治性贫血与巨幼细胞性贫血患者实验室特征比较的Meta分析
- Author:
Rong CHEN
1
;
Jianzhen SHEN
Author Information
1. 福建省血液病研究所 福建省血液病学重点实验室 福建医科大学附属协和医院血液内科 福州 350001
- From:
Journal of Leukemia & Lymphoma
2020;29(10):610-618
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the cell morphology difference of peripheral blood and bone marrow between patients with refractory anemia (RA) and megaloblastic anemia (MA).Methods:Studies were retrieved from China Notional Knowledge infrastructure (CNKI), WanFang and VIP database, and then the references listed in all studies were further searched. The data of included studies were extracted and the quality was evaluated, and then meta-analysis was made by using Stata14.0 software.Results:A total of 41 literatures and 3 192 patients were included. In terms of clinical features, the incidence of lymphadenopathy in RA patients was higher than that in MA patients ( OR = 0.43, 95% CI 0.22-0.84, P = 0.014). In the peripheral blood test, the incidence of pancytopenia, the simultaneously decreased number of young granulocytes and red granulocytes and MCV > 100 fl in MA patients was higher than that in RA patients; the differences were statistically significant ( OR = 2.56, 95% CI 2.04-3.21, P < 0.01; OR = 1.93, 95% CI 1.47-2.53, P < 0.01; OR = 4.29, 95% CI 2.20-8.37, P < 0.01), but the incidence of simultaneously severer decreased number of white blood cells and hemoglobin in RA patients was higher than that in MA patients, and the positive rate ofPAS in nuclear cells was higher, and the difference was statistically significant ( OR = 0.55, 95% CI 0.37-0.82, P = 0.003; OR = 0.00, 95% CI 0.00-0.01, P < 0.01). In the bone marrow morphology examination, the incidence of erythroid lesions, megaloblastic, granulocyte lesions and lymphoid small megakaryocytes in RA patients was higher than that in MA patients; the differences were statistically significant ( OR = 0.03, 95% CI 0.03-0.04, P < 0.01; OR = 3.55, 95% CI 2.29-5.51, P < 0.01; OR = 0.06, 95% CI 0.05-0.08, P < 0.01; OR = 0.01, 95% CI 0.00-0.01, P < 0.01). Conclusions:RA patients have a higher positive rate of peripheral nucleated PAS and severer bone marrow erythroid lesions, granulocytic lesions, and lymphoid megakaryocytes, whereas MA have severer peripheral blood pancytopenia, MCV>100 fl and simultaneous reduction of young granulocytes and red granulocytes.
