Predictive Role of Reticulocyte Fluorescence for Late Red Blood Cell Transfusion in Very Low Birth Weight Infants

IF 4.7 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Serafina Perrone , Valentina Dell'Orto , Virginia Beretta , Giuseppe De Bernardo , Maurizio Giordano , Chiara Petrolini , Giovanni Boscarino , Chiara Sodini , Annachiara Titolo , Federico Costa , Susanna Maria Roberta Esposito
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Abstract

Background

Nearly 58% of very low birth weight (VLBW) infants receive at least one red blood cell transfusion, which is not without risk. Reticulocyte fluorescence (RF) indicates the degree of cell maturation. The greater the fluorescence, the greater the immaturity of the reticulocytes.

Aim

To evaluate RF as a marker of reticulocyte maturity and to investigate its predictive value for transfusion requirement in VLBW infants.

Methods

Complete blood count was performed at 1, 7, 14, 21, and 28 d of age in 104 VLBW infants at the University Hospital of Parma. Iron supplementation was started at 15 d of life. The infants were divided into two groups: those who required transfusion after 28 d of life. (Tr) and those who did not (NTr).

Results

Twenty-seven of 104 newborns required a red blood cell transfusion after 28 d of life (Tr group). At 14 d of life, the percentage of high fluorescence reticulocyte (HFR) was significantly higher in the r group than in infants who did not receive any transfusion (NTr groups): 18.5 vs. 5%, p = 0.002. The ROC curve (AUC 74%) revealed an HFR cut-off value of 16.5% as a predictor of the need for red blood cell (RBC) transfusion.

Conclusions

Reticulocyte maturation at 14 d of life is clinically useful for estimating the qualitative impairment of erythropoiesis and predicts the risk of RBC transfusion in VLBW infants. The data suggest the need for tailored iron integration in VLBW infants to improve the quality of hematopoiesis and reduce the risk of blood transfusion.

网织红细胞荧光对极低出生体重儿晚期红细胞输注的预测作用
背景:近 58% 的极低出生体重儿(VLBW)至少接受过一次红细胞输血,这并非没有风险。网织红细胞荧光(RF)表示细胞成熟的程度。目的:评估作为网织红细胞成熟度标志的 RF,并研究其对 VLBW 婴儿输血需求的预测价值:方法:帕尔马大学医院对 104 名超低体重儿在出生后 1、7、14、21 和 28 天进行了全血细胞计数。婴儿出生后 15 天开始补充铁剂。婴儿被分为两组:出生 28 天后需要输血的婴儿(Tr)和不需要输血的婴儿(Tr)。(结果:结果:104 名新生儿中有 27 名在出生 28 天后需要输注红细胞(Tr 组)。出生 14 d 后,r 组的高荧光网织红细胞(HFR)比例明显高于未接受任何输血的婴儿(NTr 组):18.5%对5%,P = 0.002。ROC曲线(AUC 74%)显示,16.5%的HFR临界值可预测是否需要输注红细胞(RBC):结论:出生 14 天时的网织红细胞成熟度在临床上可用于估计红细胞生成的定性损伤,并预测超低体重儿输注红细胞的风险。这些数据表明,需要为超低体重儿量身定制铁整合方案,以改善造血质量并降低输血风险。
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来源期刊
Archives of Medical Research
Archives of Medical Research 医学-医学:研究与实验
CiteScore
12.50
自引率
0.00%
发文量
84
审稿时长
28 days
期刊介绍: Archives of Medical Research serves as a platform for publishing original peer-reviewed medical research, aiming to bridge gaps created by medical specialization. The journal covers three main categories - biomedical, clinical, and epidemiological contributions, along with review articles and preliminary communications. With an international scope, it presents the study of diseases from diverse perspectives, offering the medical community original investigations ranging from molecular biology to clinical epidemiology in a single publication.
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