| Objective:This study analyzes the lifespan of red blood cells in patients with acute leukemia under different disease states and explores the influencing factors of RBCS.Methods:A total of 141 acute leukemia patients who were hospitalized in the Hematology Department of Lanzhou University First Hospital from January 2022 to February2023 were collected,with a median age of 54(9-76)years.There were 87(61.7%)males and 54(38.3%)females;There were 108(76.6%)AML patients and 33(23.4%)ALL patients.According to the disease status during RBCS testing,there were 34 cases of initial diagnosis,16 cases of recurrence,82 cases of complete remission(CR),and 9 cases of non complete remission(including partially remitted and no remission).This study used CO breath test to detect RBCS,and analyzed the red blood cell lifespan levels,clinical characteristics,serological indicators,and genetic related test results of different groups of AL patients to explore the influencing factors of RBCS.This study used SPSS 25.0 to analyze clinical data of patients,with measurement data represented by median(range)and count data represented by number of cases(constituent ratio);Non parametric rank sum test was used for inter group comparison,and Spearman test was used for correlation analysis of continuous variables.Results:1.The RBCS of male AL patients was 39(8～186)d,which was shorter than that of female patients with 49(11～139)d,and the difference was statistically significant(Z=-2.599,P=0.009).2.The RBCS of AML patients was 40(9～147)d and that of ALL patients was 57(19～186)days,and the difference was statistically significant(Z=-3.305,P<0.001).3.The RBCS of patients with initial diagnosis,relapse,PR+NR and CR were32(9～147)d,50(15～115)d,21(12～46)d and 49(11～186)d,respectively,and the differences were statistically significant(Z=2.967,P<0.001),all of which were significantly shorter than the normal reference range of RBCS.Compared with CR patients,RBCS was significantly shorter in patients with initial diagnosis and PR+NR(Z=-4.041,P<0.001)(Z=-3.404,P=0.001).There was no significant difference between RBCS in patients with relapse and patients with CR(Z=-0.711,P=0.477).4.The RBCS of bone marrow MRD positive patients was 35(12～67)d,which was shorter than that of MRD negative patients with 51(11～115)d,and the difference was statistically significant(Z=-2.276,P=0.023).5.The RBCS of the RUNX1 mutation-positive patients was 32.5(11～91)d,which was shorter than that of the negative patients with 48.5(11～101)d,and the difference was statistically significant(Z=-2.181,P=0.029).The RBCS of FLT3mutation-positive patients was 26(9～81)d,which was shorter than that of negative patients with 52(11～101)d,and the difference was statistically significant(Z=-2.848,P=0.004).6.The RBCS of AL patients with blood transfusion history 3 weeks before the red blood cell life test was 21.5(11～45)d,which was shorter than that of patients without blood transfusion history 46(9～186)d,and the difference was statistically significant(Z=-4.254,P<0.001).7.The RBCS of 18 AL patients before treatment was 24(9～68)d,which was significantly shorter than that of 44(14～87)d after CR treatment,and the difference was statistically significant(Z=-3.093,P=0.002).8.The red blood cell life span of AL patients was positively correlated with leukocytes(r=0.218,P=0.010),erythropoiete(r=0.546,P<0.001),hemoglobin(r=0.524,P<0.001),platelets(r=0.386,P<0.001),blastocyte count(r=-0.260,P=0.008),erythropoietin(r=-0.449,P<0.001),and age,There was no correlation between reticulocyte count,reticulocyte ratio,lactate dehydrogenase,risk class,karyotype,WT1 gene mutation,KRAS gene mutation,efficacy after treatment,and the presence or absence of chemotherapy.Conclusion:1.The level of RBCS is related to sex,disease type,disease state,gene mutation,bone marrow hematopoietic function,and short-term red blood cell transfusion,and is independent of risk class,karyotype,efficacy,age,reticulocyte count,reticulocyte ratio,and lactate dehydrogenase.2.In patients with AL,RBCS is shortened and recovery after CR is treated,but it is still significantly shorter than the normal reference range. |
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