THE ROLE OF COMPLETE BLOOD COUNT IN PATIENTS WITH HETEROZYGOUS BETA THALASSEMIA

Year 2021, Volume: 22 Issue: 6, 457 - 460, 18.10.2021

Özge Vural Hilal Susam Şen İbrahim Eker

https://doi.org/10.18229/kocatepetip.723959

Abstract

OBJECTIVE: The goal of this study was to compare the Mean Platelet Volume (MPV), Platelet Lymphocyte ratio, and Neutrophil Lymphocyte ratio by evaluating the parameters of Complete Blood Count in healthy children and patients with heterozygous Beta-thalassemia (HBT).
MATERIAL AND METHODS: Between July 2016 and September 2019, 60 patients admitted to the pediatric hematology-oncology outpatient clinic diagnosed with HBT and 60 healthy control subjects of similar age and sex were analyzed retrospectively. Children over one year old, whose hemoglobin A2 levels were above 3.5% were included in the study population.
RESULTS: A total of 120 subjects were enrolled in this study. The HBT group included 60 subjects (32 males and 28 females) and the control group included 60 (36 males and 24 females). There were no significant differences between the two groups in terms of age and gender (p=0.29 and p=0.27). Platelet count, MPV, lymphocyte, and ferritin were significantly higher in the HBT group, whereas hemoglobin was significantly lower in the HBT group as compared with the control group.
CONCLUSIONS: Increased MPV and platelets in healthy HBT patients may cause hypercoagulability and may play a role with other risk factors in the predisposition of thrombosis in adult cases. There are very few studies on the incidence of thromboembolic events in cases with HBT. It is necessary to monitor adult HBT cases especially in terms of thromboembolic events, and to study with more cases.

Keywords

Heterozygous Beta-thalassemia, Mean Platelet Volume, Complete Blood Count, Platelet

HETEROZİGOT BETA TALASEMİLİ HASTALARDA TAM KAN SAYIMININ ROLÜ

Abstract

AMAÇ: Çalışmanın amacı heterozigot beta talasemili (HBT) olgularla sağlıklı çocuklardaki Tam Kan Sayımı parametrelerini değerlendirerek Ortalama Trombosit Hacmi (MPV), Trombosit Lenfosit oranı (PLR) ve Nötrofil Lenfosit oranını karşılaştırmaktır.
GEREÇ VE YÖNTEM: Temmuz 2016 ve Eylül 2019 tarihleri arasında HBT tanısı konulan çocuk hematoloji onkoloji polikliniğine başvuran 60 hasta ile benzer yaş ve cinsiyette 60 sağlıklı kontrol olgusu retrospektif olarak incelendi. Bir yaşın üzerindeki çocuklar arasında hemoglobin A2 düzeyi% 3.5'in üzerinde olanlar çalışmaya alındı.
BULGULAR: Toplam 120 olgu çalışmaya dahil edildi. HBT grubunda 60 olgu (32 erkek ve 28 kadın) ve kontrol grubunda da 60 (36 erkek ve 24 kadın) olgu bulunmaktaydı. İki grup arasında yaş ve cinsiyet açısından anlamlı fark yoktu (p = 0,29 ve p = 0,27). Trombosit sayısı, MPV, lenfosit ve ferritin HBT grubunda anlamlı olarak daha yüksekken, hemoglobin HBT grubunda kontrol grubuna göre anlamlı olarak daha düşüktü.
SONUÇ: Sağlıklı HBT'li hastalarda MPV ve trombosit sayısındaki artış hiperkoagulabiliteye neden olabilir ve erişkin olgularda tromboza yatkınlıkta diğer risk faktörleriyle birlikte rol oynayabilir. HBT olgularda tromboembolik olayların insidansı konusunda çok az çalışma vardır, erişkin HBT olgularını özellikle tromboembolik olaylar açısından izlemek ve daha fazla olgu ile çalışma yapmak gerekmektedir.

Keywords

Heterozigot Beta Talasemi, Tam Kan Sayımı, Ortalama Trombosit Hacmi, trombosit

References

• 1. Somervaille T. Disorders of Hemoglobin: Genetics, Pathophysiology, and Clinical Management. J R Soc Med. 2001;94(11):602‐3.
• 2. Taher A.T, Weatherall D.J, Cappellini M.D. Thalassemia. Lancet. 2018;391(10116):155-67.
• 3. Cappellini M.D, Poggiali E, Taher A.T, et al. Hypercoagulability in β-thalassemia: A statusquo. Expert Rev. Hematol. 2012;5: 505–11.
• 4. Taher A.T, Musallam K.M. Coagulation and thrombotic risk in thalassemia intermedia. Thalassemia Reports 2011; 1(2):15.
• 5. Angchaisuksiri P, Atichartakarn V, Aryurachai K, et al. Hemostatic and thrombotic markers in patients with hemoglobin E/beta-thalassemia disease. Am J Hematol. 2007;82(11):1001-4.
• 6. Farah R, Nseir W, Kagansky D, et al. The role of neutrophil-lymphocyte ratio, and mean platelet volume in detecting patients with acute venous thromboembolism. J Clin Lab Anal. 2020;34(1):23010.
• 7. Tokgoz S, Kayrak M, Akpinar Z, et al. Neutrophil lymphocyte ratio as a predictor of stroke. J Stroke Cerebrovasc Dis. 2013;22: 1169-74.
• 8. Çiçek G, Açıkgoz SK, Bozbay M, et al. Neutrophil lymphocyte ratio and platelet-lymphocyte ratio combination can predict prognosis in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Angiology. 2015;66: 441-7.
• 9. Cappellini MD, Motta I. New therapeutic targets in transfusion-dependent and independent thalassemia. Hematology Am Soc Hematol Educ Program. 2017;(1):278‐83.
• 10. Succar J, Musallam KM, Taher AT. Thalassemia and Venous Thromboembolism Mediterr J Hematol Infect Dis 2011; 3 (1):e2011025.
• 11. Ming L, Jiang Z, Ma J, et al. Platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, and platelet indices in patients with acute deep vein thrombosis. Vasa.2018; 47(2): 143–7.
• 12. Gasparyan AY, Ayvazyan L, Mikhailidis DP, et al. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011; 17: 47–58.
• 13. Cikrikcioglu MA, Celik K, Ekinci I et al. Mean Platelet Volume in Heterozygous Beta Thalassaemia. Acta Haematol. 2017; 137(2):100-5.
• 14. Braekkan SK, Mathiesen EB, Njølstad I, et al. Mean platelet volume is a risk factor for venous thromboembolism: The Tromso Study, Tromso, Norway. J Thromb Haemost. 2010; 8:157-62.
• 15. Cay N, Ipek A, Gumus M, et al. Platelet activity indices in patients with deep vein thrombosis. Clin Appl Thromb Hemost. 2012; 18: 206-10.
• 16. Cil H, Yavuz C, Islamoglu Y, et al. Platelet count and mean platelet volume in patients with in-hospital deep venous thrombosis. Clin Appl Thromb Hemost. 2012; 18: 650-3.
• 17. Sleiman J, Tarhini A, Bou-Fakhredin R, et al. Non-Transfusion-Dependent Thalassemia: An Update on Complications and Management. Int J Mol Sci. 2018;19(1): 182.
• 18. Dentali F, Romualdi E, Ageno W, et al. Thalassemia trait and arterial thromboembolic events: a systematic review and a meta-analysis of the literature. J Thromb Haemost. 2011; 9(5):917-21.
• 19. Liu X, Wen J, Xu Y, et al. Increased risk of arterial thromboembolic events in transfusion-naive thalassemia: a nation wide population-based study. J Investig Med. 2019;67(5):826-32.
• 20. Balta S, Ozturk C. The platelet-lymphocyte ratio: A simple, inexpensive, and rapid prognostic marker for cardiovascular events. Platelets. 2015; 26: 680–1.
• 21. Kurtipek E, Buyukterzi Z, Buyukterzi M et al. Endothelial dysfunction in patients with pulmonary thromboembolism: neutrophil to lymphocyte ratio and platelet to lymphocyte ratio. Clin Respir J. 2017; 11: 78–82.