Investigation On Elevated Fetal Hemoglobin Level In Non-genetic Blood Diseases And Its Clinical Correlation

Objective: To discuss elevated fetal hemoglobin (HbF>2%) related non-genetic blood disease and its clinical significance.Method: Study 170 patients admitted in our hospital during the recent 5 years, including myelodysplastic syndrome, aplastic anemia, chronic myelocytic leukemia, acute lymphoblastic leukemia, acute myelocytic leukemia and hemolytic anemia. The medical case histories were minutely investigated by physical examinations as well as peripheral blood regular test, hemoglobin electrophoresis and peptide chain analysis, bone marrow morphology and pathology, immunological classification of leukemia, chromosome culture, reticulocyte count, hemolysis test, erythrocyte osmotic fragility, autoimmune antibody, glucose-6-phosphate dehydrogenase activity, serum copper-protein, urine copper, liver function for the diagnosis of disease. Record their results of hemoglobin electrophoresis and peptide chain analysis before therapy.Result: Among the 170 non-genetic blood disease patients, 72 patients(42.4%) have HbF above 2.0%, and 17 patients(10.0%) have HbF above 5.0%, including 22 AA patients(56.4%), 27 MDS patients(50.9%), 7 CML patients(43.8%), 5 ALL patients(22.7%), 6 AML patients(40%), 5 HA patients(20%). HbF values of MDS, AA, CML, ALL, AML and HA are all elevated compared with normal control group. The difference has statistical significance.Conclusion: (1) Secondary increase of HbF can be seen in these common non-genetic blood diseases——AA,MDS,AML,CML,ALL and HA. Patients with elevated HbF level above 2.0% account for 42.4% of all the 170, while 32.4% have slight elevated HbF level (2.0%~5.0%) ,the rest 10.0% have moderate elevated HbF level.(2)There is no significant difference on HbF level between AA and MDS; the same with CML,ALL and AML. (3)In our ALL group, there exist no firm correlations between HbF level and WBC, platelet count of peripheral blood, immunological classification, chromosome. (4)In total patient group and AA group, the relationship between HbF and MCV value is linear, and correlation is positive, which indicates that F-blast red cells might have larger volume. In ALL group, the relationship between HbF and Hb value is linear, and correlation is positive, which might indicates higher HbF level impoves clinical anemia symptoms.