"Type O blood, the MCHC, and the reticulocyte count impact the early recurrence of primary warm-antibody autoimmune hemolytic anemia in children: A retrospective cohort analysis"

作者全名："Li, Jiacheng; An, Xizhou; Xu, Ximing; Xiao, Li; Wang, Yang; Zhu, Yao; Huang, Lan; Zhang, Kainan; Yao, Xinyuan; Yi, Weijia; Qin, Jiebin; Yu, Jie"

作者地址："[Li, Jiacheng; An, Xizhou; Xiao, Li; Wang, Yang; Zhu, Yao; Huang, Lan; Zhang, Kainan; Yao, Xinyuan; Yi, Weijia; Qin, Jiebin; Yu, Jie] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Hematol & Oncol, Chongqing Key Lab Pediat,Childrens Hosp,Minist Edu, Chongqing, Peoples R China; [Xu, Ximing; Xiao, Li] Chongqing Med Univ, Big Data Ctr Childrens Med Care, Childrens Hosp, Chongqing, Peoples R China"

通信作者："Yu, J (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Hematol & Oncol, Chongqing Key Lab Pediat,Childrens Hosp,Minist Edu, Chongqing, Peoples R China."

来源：FRONTIERS IN PEDIATRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000874604800001

JCR分区：Q1

影响因子：2.6

年份：2022

卷号：10

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：primary autoimmune hemolytic anemia; warm-antibody; recurrence; risk indicators; children

摘要："ObjectivePrimary warm-antibody autoimmune hemolytic anemia (w-AIHA) is prone to recurrence in children. In this study, we aimed to identify risk indicators for the early recurrence of primary w-AIHA and construct an effective recurrence risk assessment model. MethodsThis was a retrospective cohort study. The clinical data of patients hospitalized with primary w-AIHA in the Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, between 1 January 2018 and 30 September 2021, were collected at the initial diagnosis. Univariate and multivariate logistic regression analyses were used to determine risk indicators for the early recurrence of primary w-AIHA in children, and ROC curve and Kaplan-Meier survival analyses were used for verification. Finally, a risk assessment model for early recurrence in children with primary w-AIHA was constructed using Cox regression and visualized using a nomogram. The model was also verified internally and externally. ResultsThis study included 62 children with primary w-AIHA. Of which, 18 experienced recurrence 1 year after the initial diagnosis. The univariate and multivariate logistic regression analyses showed that type O blood and the reticulocyte count (Ret) were risk indicators for the early recurrence of pediatric primary w-AIHA (P = 0.009, 0.047, respectively). The mean corpuscular hemoglobin concentration (MCHC) is a protective factor (P = 0.040). According to the ROC curve and Kaplan-Meier survival analyses, children with primary w-AIHA whose blood type was O or had an MCHC of <313.5 pg/fL or a Ret of >= 0.161x10(12)/L had a higher risk of early recurrence (HR = 2.640, 4.430 and 4.450, respectively, and P = 0.040, 0.015 and 0.018, respectively). The blood types (O), MCHCs, and Rets of 56 patients were incorporated into the Cox regression model, and the recurrence risk assessment model for children with primary w-AIHA was successfully constructed and visualized using a nomogram. The calibration curves and decision-curve analysis (DCA) suggested that the risk model has clinical applicability and effectiveness. ConclusionChildren with type O blood and an MCHC value of <313.5 pg/fL or a Ret value of >= 0.161x10(12)/L have a higher risk of early recurrence. The risk assessment model for the early recurrence of pediatric primary w-AIHA constructed in this study has good clinical applicability and effectiveness."

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